Ali Rama Ahmed, Hemidan Ahmed Gamal, Kadry Hamed Mohamed, Saad Ahmed Samy
From the Faculty of Medicine, Cairo University, Cairo, Egypt.
Private Practice, Cairo, Egypt.
Plast Reconstr Surg Glob Open. 2024 Mar 4;12(3):e5673. doi: 10.1097/GOX.0000000000005673. eCollection 2024 Mar.
The loss of soft tissue coverage of tendons is a challenging reconstructive problem after acute hand trauma. Subsequent tendon adhesions and the loss of range of movement in addition to the poor aesthetic outcome and donor site scarring should be avoided when deciding the plan of management. Pelnac is one of the commonly used skin substitutes in reconstructive surgery that can be used for coverage of exposed tendons, but the postoperative functional outcome needs to be addressed in detail.
Twenty-six patients with acute isolated tendon injuries distal to the wrist joint were included. Two-stage reconstructive procedures were performed; the first one was the application of Pelnac. The second stage was carried out after the complete integration of Pelnac via the application of a split-thickness graft. The function outcome assesses the return of the normal range of motion to the affected hand and the QuickDASH score questionnaire. The aesthetic outcome was assessed using the Vancouver scar scale.
The Pelnac was integrated in 100% of cases, with complete grafts taken in 22 of 26 patients. The mean QuickDASH score was 20.5 ± 15.7, and mean Vancouver scar scale was 3.53 ± 3.2. The full range of motion returned in 22 of 26 patients.
Using Pelnac to cover the exposed hand tendons in an acute setting is a convenient and efficient procedure with minimal morbidity. It can offer a good option for their coverage with preservation of hand function and acceptable aesthetic outcome.
急性手部创伤后，肌腱软组织覆盖缺失是一个具有挑战性的重建问题。在制定治疗方案时，应避免随后出现的肌腱粘连、活动范围丧失，以及美学效果不佳和供区瘢痕形成等情况。Pelnac是重建手术中常用的皮肤替代物之一，可用于覆盖外露肌腱，但术后功能结果需要详细探讨。
纳入26例腕关节远端急性孤立性肌腱损伤患者。采用两阶段重建手术；第一阶段应用Pelnac。第二阶段在Pelnac完全整合后，通过应用中厚皮片进行。功能结果通过评估患手正常活动范围的恢复情况和QuickDASH评分问卷来评估。美学效果采用温哥华瘢痕量表进行评估。
Pelnac在100%的病例中实现整合，26例患者中有22例皮片完全成活。QuickDASH评分的平均值为20.5±15.7，温哥华瘢痕量表的平均值为3.53±3.2。26例患者中有22例恢复了全部活动范围。
在急性情况下使用Pelnac覆盖外露的手部肌腱是一种简便有效的手术，并发症发生率极低。它可为肌腱覆盖提供一个良好的选择，同时保留手部功能并获得可接受的美学效果。
