Institute of Plastic and Craniofacial Surgery, SOBRAPAR Hospital.
Discipline of Neurosurgery, University of Campinas (UNICAMP), Campinas, Brazil.
J Craniofac Surg. 2021;32(1):184-186. doi: 10.1097/SCS.0000000000007064.
Hand reconstruction for patients with Apert syndrome is a critical step in comprehensive care and enables this population to gain significant hand function. Digit separation for Apert syndrome, as described in most algorithms, is finalized using local flaps and full-thickness skin grafts. The objective of this study is to report our experience using local flaps and partial-thickness skin grafts after digit separation for Apert hand reconstruction.
An observational retrospective study was performed with Apert patients whose hands were reconstructed between January 2007 and July 2019 using local flaps and partial-thickness skin grafts after digit separation. Demographic data and outcome data were verified and recorded.
Out of a total of 75 Apert patients who underwent hand reconstruction, 12 underwent hand reconstruction utilizing local flaps and partial-thickness skin grafts. The average patient age at the time of the first procedure was 1.9 years. These 12 patients were stratified according to Upton hand severity, 3 being type I (25%), 3 being type II (25%) and 6 being type III (50%). Mean follow up provided to all patients in this study was 1.8 years and donor site-related complications were seen in 2 patients (16.6%). No flexion scar contracture was observed in any of the patients who received partial-thickness skin grafts.
The use of local flaps along with partial-thickness skin grafts to finalize digit separation for patients with Apert syndrome is an effective technique that reduces donor site morbidity and does not result in flexion scar contracture.
对于 Apert 综合征患者，手部重建是全面护理的关键步骤，使该人群获得显著的手部功能。大多数算法中描述的 Apert 综合征的手指分离，最终采用局部皮瓣和全厚皮片完成。本研究旨在报告我们在 Apert 手重建中使用局部皮瓣和部分厚度皮片进行手指分离后的经验。
对 2007 年 1 月至 2019 年 7 月期间接受局部皮瓣和部分厚度皮片进行手指分离后的 Apert 患者进行观察性回顾性研究。验证并记录人口统计学数据和结果数据。
在总共 75 名接受手部重建的 Apert 患者中，有 12 名患者接受了局部皮瓣和部分厚度皮片的手部重建。首次手术时的平均患者年龄为 1.9 岁。这 12 名患者根据 Upton 手严重程度分层，3 型为 I 型（25%），3 型为 II 型（25%），6 型为 III 型（50%）。本研究中所有患者的平均随访时间为 1.8 年，有 2 名患者（16.6%）出现供区相关并发症。接受部分厚度皮片的患者均未见屈肌瘢痕挛缩。
对于 Apert 综合征患者，使用局部皮瓣联合部分厚度皮片完成手指分离是一种有效的技术，可降低供区发病率，且不会导致屈肌瘢痕挛缩。
