Hihara Masakatsu, Takegawa Masayasu, Kakudo Natsuko, Mitsui Toshihito, Fukui Michika
Department of Plastic and Reconstructive Surgery, Kansai Medical University, Osaka, Japan.
J Surg Case Rep. 2022 Oct 20;2022(10):rjac481. doi: 10.1093/jscr/rjac481. eCollection 2022 Oct.
Treatment of axillary contracture after extensive deep burns is a serious clinical challenge. Various surgical intervention for releasing contracture using skin grafts, flaps and artificial skin have been used, but no consensus on the optimal treatment has been obtained. A standardized two-stage debridement strategy using an electric dermatome (for eschar) and the Versajet™ hydrosurgery system (for slough) can be an appropriate debridement strategy that provides reliable wound bed preparation in cases of for axillary deep burns. Using this approach focus on management of acute axillary burns, it is possible to avoid engraftment failure and prevent contracture caused by prolonged infection. This treatment strategy can be standardized and can be performed easily, even by non-experts.
大面积深度烧伤后腋窝挛缩的治疗是一项严峻的临床挑战。已经采用了各种使用皮肤移植、皮瓣和人工皮肤来松解挛缩的手术干预方法，但尚未就最佳治疗方法达成共识。使用电动取皮刀（用于焦痂）和Versajet™水刀手术系统（用于腐肉）的标准化两阶段清创策略可能是一种合适的清创策略，在腋窝深度烧伤的病例中能提供可靠的创面准备。采用这种专注于急性腋窝烧伤管理的方法，可以避免移植失败并防止因长期感染导致的挛缩。这种治疗策略可以标准化，甚至非专业人员也能轻松实施。
