小儿手烧伤后瘢痕畸形的综合治疗经验  

Experience of combined therapy on treating cicatrical deformity caused by pediatric hand burns

作　　者：桂国庆 姚玉婷[2] 付建华[2] 文辉才[2] 

机构地区：[1]江西省九江县人民医院外科,江西九江332100 [2]江西南昌大学第一附属医院整形外科

出　　处：《中国美容医学》2012年第6期887-889,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:总结56例小儿手烧伤后及早进行瘢痕畸形修复的综合治疗经验。方法:2006年8月～2010年12月对56例(67只手)烧伤后2～6个月手畸形患儿,在气管插管全身麻醉下手术,采用瘢痕松解或切除植皮、局部"Z"成形或"V-Y"皮瓣转移推进、皮瓣修复。术后即进行抗瘢痕挛缩的康复训练。结果:38例患儿移植皮片全部存活;10例患儿移植皮片表皮有少许脱落;6例患儿移植皮片切口边缘有开裂、部分皮片坏死,经换药后愈合;2例患儿移植皮片大部分感染坏死,需再次行植皮手术。术后经过6个月康复锻炼后,手部功能优18例(20只手),功能良好25例(30只手),可7例(9只手),差6例(8只手)。结论:小儿手瘢痕畸形的治疗时间、术中细节及早期进行康复锻炼对术后的效果有很大的影响。Objective To summarize the experience of combined therapy of surgery and recovery on treating 56 cases of cicatrical deformity caused by pediatric hand burns in early time. Methods From August 2006 to December 2010,56 cases （67 hands） caused by pediatric hand burns after 2~6 months were entered the trial.All of the patients were performed under the general anesthesia with tracheal intubation. Using scar release or removal and skin grafh using Z- plasty or V-Y flap transfer or advance and flap transfer.All the patients were conducting rehabilitation training to resist scar contracture after operation. Results The all of grafting skin had survival in 38 cases^there was little excoriation on the grafting skin in 10 cases：The edge of grafting skin had craking and part of grafting skin were necrosis in 6 cases. After the medicine treatment,the wound was healed. A majority of the grafting skin was infection and necrosis,which was needed planting again in 2 cases. By rehabilitation training after 6 months of operation,the function of hands was superior in 18cases （20 hands）,well in 25cases （30 hands）,better in 7cases （9 hands） and bad in 6 cases （8 hands）. Conclusion When treating pediatric hand burns,treatment time,intraoperative details and early rehabilitation exercise have great effect on postoperation effects.

关 键 词：小儿手烧伤 瘢痕畸形 手术 康复 经验 

分 类 号：R622[医药卫生—整形外科]