摘要
目的探讨手部烧伤瘢痕挛缩畸形行整形修复的临床疗效。方法70例手部烧伤瘢痕挛缩畸形患者作为研究对象,根据烧伤程度不同选择不同术式,手部瘢痕松解切除后全厚皮移植修复,瘢痕松解切除后伴有深部组织暴露者选择皮瓣移植修复。观察患者的临床疗效、手术前后手部关节功能及日常生活活动能力、创面愈合指标及并发症发生情况。结果70例患者中,显效32例(45.71%),有效35例(50.00%),无效3例(4.29%),治疗总有效率为95.71%(67/70)。术后3个月,患者的手指关节总活动度(TAM)(194.13±11.51)°、日常生活活动能力量表(ADL)评分(75.24±6.39)分均高于术前的(135.37±5.92)°、(39.87±4.26)分(P<0.05)。患者的创面愈合时间为(2.13±3.26)d,手部美观度评分为(89.02±5.67)分。无皮肤坏死、再次瘢痕挛缩发生,发生感染1例(1.43%)、溃疡2例(2.86%),并发症发生率为4.29%(3/70)。结论瘢痕松解切除后全厚皮移植修复、皮瓣移植修复治疗手部烧伤瘢痕挛缩畸形的临床疗效显著,创面愈合时间短,并发症发生率低,手部外形及功能恢复良好。
Objective To explore the clinical efficacy of plastic repair for hand burn scar contracture deformity.Methods 70 cases of hand burn scar contracture deformity were taken as the research subjects,and different surgical procedures were selected according to different burn degrees.After hand scar release and excision,full-thickness skin graft was used for repair,and those with deep tissue exposure after scar release and excision chose skin flap transplantation for repair.The clinical efficacy,hand joint function and daily living ability,wound healing index before and after surgery,and complications were observed.Results Among 70 patients,32 cases(45.71%)were markedly effective,35 cases(50.00%)were effective,3 cases(4.29%)were ineffective,and the total effective rate was 95.71%(67/70).The total active movement(TAM)and activities of daily living(ADL)at 3 months after surgery were(194.13±11.51)°and(75.24±6.39)points,which were higher than(135.37±5.92)°and(39.87±4.26)points before surgery(P<0.05).The wound healing time was(2.13±3.26)d,and the hand aesthetic score was(89.02±5.67)points.There was no skin necrosis and scar contracture,only 1 case(1.43%)was infected and 2 cases(2.86%)were ulcerated,with a complication rate of 4.29%(3/70).Conclusion Full-thickness skin grafting and skin flap repair and after scar release and excision have obvious clinical effects in treating hand burn scar contracture deformity,with short wound healing time,low complication rate and good recovery of hand shape and function.
作者
邓建文
苏胜年
DENG Jian-wen;SU Sheng-nian(Department of Burn and Wound Repair,Sanming City First Hospital,Sanming 365000,China)
出处
《中国现代药物应用》
2025年第11期53-56,共4页
Chinese Journal of Modern Drug Application
关键词
手部烧伤瘢痕挛缩畸形
整形修复
临床疗效
Hand burn scar contracture deformity
Plastic repair
Clinical efficacy
