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改良手套状腹部皮瓣用于手背及手指烧伤后瘢痕挛缩重建:1例报告

The use of modified glove-like abdominal flap for reconstruction of contracture following burns of dorsal hand and fingers: A case report.

作者信息

Putri Almahitta Cintami, Runisa Puti Adla, Hasibuan Lisa, Faried Ahmad, Mose Johanes Cornelius

机构信息

Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjajaran (FK UNPAD)-Dr. Hasan Sadikin Hospital, Bandung, Indonesia; Graduate School of Biomedical Sciences, Doctoral Program, FK UNPAD, Bandung, Indonesia.

Division of Plastic Reconstructive and Aesthetic Surgery, Department of Surgery, Faculty of Medicine, Universitas Padjajaran (FK UNPAD)-Dr. Hasan Sadikin Hospital, Bandung, Indonesia.

出版信息

Int J Surg Case Rep. 2022 May;94:106962. doi: 10.1016/j.ijscr.2022.106962. Epub 2022 Mar 29.

Abstract

INTRODUCTION AND IMPORTANCE

Burn contracture has been a challenge for its acquired functional disabilities and deformities. Surgical reconstruction poses a significant challenge for optimal aesthetic and functional improvement. Super thin abdominal skin pedicle flap can be used, but it has only one pedicle from one site of abdomen and needs tissue expander for a larger defect. The use of modified glove-like abdominal flap has been stated to be an option mainly for the use on acute hand burn. In this study, application of the modified glove-like abdominal flap was applied to contracture of dorsal hand and fingers.

CASE PRESENTATION

A 39-year-old male patient with severe contracted hand, eight-month post-burn injury presented at outpatient clinic Santosa Central Hospital in 2017. Multiple series of surgeries were performed on this patient, consisting of released contracture, defect closure using a modified "glove-like" thin abdominal flap, and flap separation.

CLINICAL DISCUSSION

Abdominal flap has been the commonly used technique but has the disadvantage of being bulky. Glove-like abdominal flap, a subcutaneous layer plane flap, can be performed simply, safely, and briefly. It has been published mainly for reconstruction for acute burn hand injuries, not for burn hand contracture.

CONCLUSION

The use of modified glove abdominal flap technique for reconstruction in hand burn contracture gives a satisfactory result in terms of functional and aesthetic outcome and can be an option in reconstruction in contracted dorsal hand and fingers.

摘要

引言与重要性

烧伤挛缩因其导致的功能残疾和畸形一直是个难题。手术重建在实现最佳美学和功能改善方面面临重大挑战。超薄腹部带蒂皮瓣可被使用,但它仅从腹部的一个部位有一个蒂,对于较大缺损需要组织扩张器。改良手套状腹部皮瓣的应用主要被认为是用于急性手部烧伤的一种选择。在本研究中,改良手套状腹部皮瓣被应用于手背和手指挛缩。

病例介绍

一名39岁男性患者,烧伤后8个月,手部严重挛缩,于2017年在三多中央医院门诊就诊。对该患者进行了多次手术,包括松解挛缩、使用改良“手套状”超薄腹部皮瓣闭合缺损以及皮瓣分离。

临床讨论

腹部皮瓣一直是常用技术,但有体积庞大的缺点。手套状腹部皮瓣是一种皮下层平面皮瓣,操作简单、安全且耗时短。它主要发表用于急性烧伤手部损伤的重建,而非烧伤手部挛缩。

结论

改良手套状腹部皮瓣技术用于手部烧伤挛缩的重建在功能和美学效果方面取得了满意结果,可作为手背和手指挛缩重建的一种选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f40d/9006244/83a913bd23b0/gr1.jpg

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