Ferrari Bien R, Werker Paul M N
University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
J Hand Surg Eur Vol. 2019 Mar;44(3):296-303. doi: 10.1177/1753193418808183. Epub 2018 Oct 30.
Syndactyly correction without skin grafting is advocated because it prevents graft-related complications and donor site morbidity. In this cross-sectional study, we compared satisfaction among patients who underwent correction with and without skin grafting to determine preference based on subjective and objective parameters. Retrospective chart analysis was performed among 27 patients (49 webs) who were seen at follow-up after a median follow-up period of 7.4 years, at which the Patient and Observer Scar Assessment Scale, the Withey score and a satisfaction survey were used. Notably, there were no significant differences in complication rates or observer rated scar scores. Although the need for an additional surgical procedure was higher after skin grafting, patient-rated satisfaction scores were similar irrespective of the use of grafting. Our data suggest that corrections can best be performed without skin grafts if seeking to minimize the need for an additional procedure, but that the use of skin grafts does not appear to affect patient satisfaction. Level of evidence: IV.
提倡进行不植皮的并指矫正术,因为它能预防与植皮相关的并发症以及供区发病率。在这项横断面研究中,我们比较了接受植皮和未接受植皮矫正术的患者的满意度,以根据主观和客观参数确定偏好。对27例患者(49个指蹼)进行了回顾性图表分析,这些患者在中位随访期7.4年后接受随访,随访时使用了患者和观察者瘢痕评估量表、维西评分以及满意度调查。值得注意的是,并发症发生率或观察者评定的瘢痕评分没有显著差异。虽然植皮后需要额外手术的情况更多,但无论是否使用植皮,患者评定的满意度评分相似。我们的数据表明,如果想尽量减少额外手术的需求,最好进行不植皮的矫正术,但植皮的使用似乎不会影响患者满意度。证据级别:IV。