Payen M, Luc F, Sales de Gauzy J, Accadbled F, Abid A
Clinique chirurgicale infantile, hôpital Charles-Nicolle, CHU de Rouen, 37, boulevard Gambetta, 76038 Rouen, France.
Clinique chirurgicale infantile, hôpital Charles-Nicolle, CHU de Rouen, 37, boulevard Gambetta, 76038 Rouen, France.
Ann Chir Plast Esthet. 2022 Mar;67(2):73-80. doi: 10.1016/j.anplas.2022.01.004. Epub 2022 Feb 17.
Constriction grooves are typical abnormalities of constriction band syndrome (CBS). Treatment by complete excision and Z-plastic closure is the gold standard for release of these grooves. However, the results of these Z-plasties are often judged to be aesthetically insufficient. The hypothesis was that direct excisional surgery without Z-plasty gave better aesthetic results. The objectives of this study were (1) to evaluate the clinicaal results of the release of amniotic furrows by simple hemi-circumferential excision without resorting to Z-plasties, (2) to study the occurrence of complications, (3) to study the factors leading to complications.
All patients who had release of amniotic grooves by linear hemi-circumferential excision and closure without Z-plasties were included between 2011 and 2017. Release of complete or circumferential grooves was carried out in 2 stages. Clinical evaluation was based on parental satisfaction with the aesthetic appearance and occurrence of any complications or recurrence.
Fourteen grooves including 8 circumferential and 6 semi-circumferential were released, in 7 patients. Average age at surgery was 9 months (3-18 months). Some patients had 1, 2 or 3 surgeries. The groove was localized in 7 cases in the leg, in 4 in the fingers and in 1 in the thigh, toes and forearm. At the last average follow-up of 25 months (12-41 months), all parents were very satisfied with the aesthetic appearance. No complications, including scarring, vascular or lymphatic disease, were noted. No recurrence was noted.
Release of amniotic grooves by simple linear hemi-circumferential excision without Z-plasties is a simple, safe and effective technique. The aesthetic results are very satisfactory.
IV - retrospective study.
缩窄沟是缩窄带综合征（CBS）的典型异常表现。通过完全切除和Z成形术闭合进行治疗是松解这些沟的金标准。然而，这些Z成形术的效果在美学上往往被认为是不充分的。假设是不进行Z成形术的直接切除手术能带来更好的美学效果。本研究的目的是：（1）评估通过简单的半周向切除而不采用Z成形术来松解羊膜沟的临床效果；（2）研究并发症的发生情况；（3）研究导致并发症的因素。
纳入2011年至2017年间所有通过线性半周向切除并闭合而不采用Z成形术来松解羊膜沟的患者。完全或周向沟的松解分两期进行。临床评估基于家长对美学外观的满意度以及任何并发症或复发情况。
7例患者共松解了14条沟，其中8条为周向沟，6条为半周向沟。手术时的平均年龄为9个月（3 - 18个月）。一些患者接受了1次、2次或3次手术。沟位于腿部7例，手指4例，大腿、脚趾和前臂各1例。在最后一次平均随访25个月（12 - 41个月）时，所有家长对美学外观都非常满意。未发现包括瘢痕形成、血管或淋巴疾病在内的并发症。未观察到复发情况。
通过简单的线性半周向切除而不采用Z成形术来松解羊膜沟是一种简单、安全且有效的技术。美学效果非常令人满意。
IV - 回顾性研究。
