Kumar Suneel, Khan Faisal Akhlaq Ali, Ali Hyder, Kiran Saba
Suneel Kumar, FCPS-2, Post Graduate Trainee of Plastic Surgery. Department of Plastics and Reconstructive Surgery, Dow University of Health Sciences, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan.
Faisal Akhlaq Ali Khan, Chairperson and Assistant Professor, Head of Department of Plastic Surgery. Department of Plastics and Reconstructive Surgery, Dow University of Health Sciences, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan.
Pak J Med Sci. 2020 Sep-Oct;36(6):1387-1391. doi: 10.12669/pjms.36.6.2206.
To evaluate the efficacy of different surgical procedures on post burn contracture of hand.
A quasi-experimental study design was conducted at the Department of Plastics and Reconstructive Surgery, Dow University of Health Science, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan from 1 June 2019 to 30 November 2019. Ninety-three participants of burned hand contracture of either gender, aged between 6- 60 years were included in the study. Resurfacing surgery with skin graft and loco-regional flaps were done according to type of contracture with individualization for each patient. All patients were kept under follow up for ninety days to assess efficacy of contracture release for each surgical procedure was noted. SPSS version 23 was used to analyse data.
Full thickness skin graft (FTSG) was performed in 60.2% cases, 17.2% with split thickness skin graft (STSG) and 12.9% with cross finger flaps. About 25% of recurrence was observed in cross finger flaps, whereas no recurrence was seen in Z-plasties and posterior interosseous flap. The significant association was between recurrence and surgical procedures (p<0.05).
Z-plasty followed by FTSG was effective in the management of post burn contractures of hand.
评估不同手术方法治疗手部烧伤后挛缩的疗效。
于2019年6月1日至2019年11月30日在巴基斯坦卡拉奇公民医院鲁思·KM·普法乌博士健康科学道氏大学整形与重建外科进行了一项准实验研究。该研究纳入了93例年龄在6至60岁之间的手部烧伤挛缩患者,男女不限。根据挛缩类型并针对每位患者进行个体化处理,采用皮肤移植和局部皮瓣进行创面修复手术。所有患者均接受90天的随访,以评估每种手术方法松解挛缩的疗效,并记录相关情况。使用SPSS 23版软件进行数据分析。
60.2%的病例采用了全厚皮片移植(FTSG),17.2%采用了中厚皮片移植(STSG),12.9%采用了邻指皮瓣。邻指皮瓣观察到约25%的复发率,而Z成形术和骨间后皮瓣未见复发。复发与手术方法之间存在显著关联(p<0.05)。
Z成形术联合全厚皮片移植在手部烧伤后挛缩的治疗中效果良好。