Department of Burns and Plastic Surgery, The Fourth Medical Center of Chinese PLA General Hospital, Beijing, China.
Int Wound J. 2023 Sep;20(7):2718-2725. doi: 10.1111/iwj.14145. Epub 2023 Mar 22.
The study aimed to assess the functional and aesthetic outcomes of abdominal full-thickness skin grafts (FTSGs) in paediatric postburn digital and palmar flexion contractures. The digital and palmar functions and aesthetics of 50 children who met the criteria were evaluated at pre-operation, the 3rd- and 12th-month post-operation, respectively. In the evaluation, the Vancouver Scar Scale (VSS), total active movement (TAM), and Jebsen-Taylor Hand Function Test (JHFT) were used. The contralateral, unaffected hand served as the criteria for functional recovery. The complications of donor sites were observed, and the take rate of skin grafts was calculated. The VSS scores at the 3rd and 12th months post-operation were lower than those before the operation. The TAM of each finger was improved at the 3rd and 12th months post-operation, compared with that before the operation. There was a significant difference in the time to complete the JHFT between the affected hand and the unaffected at the 3rd month post-operation, but no significant difference between them at the 12th month post-operation. The excellent and good take rate of the skin grafts was 90.00%.No donor site complications were observed. The abdominal FTSGs are effective in repairing paediatric digital and palmar scar contractures, with satisfying functional and aesthetic results, especially in large defects after scar release and resection.
本研究旨在评估腹部全厚皮片（FTSG）在儿童烧伤后手指和手掌屈曲挛缩中的功能和美学效果。对符合标准的 50 名儿童分别在术前、术后第 3 个月和第 12 个月进行手指和手掌功能和美学评估。在评估中，使用温哥华瘢痕量表（VSS）、总主动活动度（TAM）和 Jebsen-Taylor 手功能测试（JHFT）。以健侧未受累手作为功能恢复的标准。观察供区并发症，计算皮片成活率。术后第 3 个月和第 12 个月的 VSS 评分均低于术前，术后第 3 个月和第 12 个月各手指 TAM 均较术前改善，差异有统计学意义（P<0.05）。术后第 3 个月患手完成 JHFT 的时间与健手比较，差异有统计学意义（P<0.05），但术后第 12 个月两组间比较，差异无统计学意义（P>0.05）。皮片成活率优秀和良好率为 90.00%。供区无并发症。腹部 FTSG 修复儿童手指和手掌瘢痕挛缩有效，功能和美学效果满意，尤其是在瘢痕松解和切除后的较大缺损。
