摘要
目的观察穿支皮瓣修复大面积烧伤后瘢痕挛缩的临床效果,为临床术式选择提供参考。方法选取2020年7月至2023年7月黄石市第五医院烧伤整形外科收治的93例大面积烧伤后瘢痕挛缩患者为研究对象,根据修复方式不同分为观察组(52例)和对照组(41例),观察组采用穿支皮瓣修复治疗,对照组采用人工真皮移植治疗。比较两组患者的植皮(皮瓣)存活率、瘢痕挛缩复发率、住院病程、温哥华瘢痕评定量表(VSS)评分、生活质量量表(QOL)评分、关节活动度(ROM)评分、外观满意度评分,比较两组患者并发症发生情况。结果两组患者植皮(皮瓣)存活率比较,差异无统计学意义(P>0.05)。观察组瘢痕挛缩复发率低于对照组,住院病程短于对照组,差异有统计学意义(P<0.05)。观察组患者VSS评分、并发症总发生率低于对照组,QOL评分、ROM评分及外观满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论对于大面积烧伤后瘢痕挛缩患者采用穿支皮瓣修复,瘢痕挛缩复发率低、住院病程短、治疗效果好,能明显提升患者生活质量和外部美观性,并发症少。
Objective To evaluate the cosmetic outcomes of perforator flap for repairing scar contracture in large-area burns,and to provide clinical guidance for surgical selection.Methods A total of 93 patients with post-burn scar contracture were enrolled in our hospital from July 2020 to July 2023 and divided into an observation group(n=52,perforator flap repair)and a control group(n=41,artificial dermal transplantation)based on repair method..Comparisons included skin graft/flap survival rate,scar contracture recurrence rate,hospital stay duration,vancouver scar scale(VSS)score,quality of life(QOL)score,range of motion(ROM)score,appearance satisfaction score,and postoperative complication rates between the two groups.Results No significant difference was observed in skin graft/flap survival rate between the two groups(P>0.05).The observation group exhibited a lower scar contracture recurrence rate and shorter hospital stays than the control group(P<0.05).Compared to the control group,the observation group showed significantly lower VSS scores and higher QOL scores,ROM scores,and appearance satisfaction scores(P<0.05).Additionally,the complication rate was significantly lower in the observation group(P<0.05).Conclusion In patients with post-burn scar contracture,perforator flaps repair is associated with lower recurrence rates,shorter hospital stays,superior therapeutic outcomes,and significant improvements in quality of life and aesthetics satisfaction,along with fewer complications.
作者
吴贞天
沈文川
汤俊
李儒进
丁若虹
WU Zhentian;SHEN Wenchuan;TANG Jun;LI Rujin;DING Ruohong(Department of Burn and plastic surgery,Huangshi fifth hospital,Huangshi,Hubei 435005,China)
出处
《转化医学杂志》
2025年第7期141-144,共4页
Translational Medicine Journal
关键词
烧伤
瘢痕挛缩
穿支皮瓣
皮肤移植
治疗结果
Burn
Scar contracture
Perforator flap
Artificial dermis transplantation
Effect observation
