手烧伤瘢痕挛缩的预防和治疗研究进展  

Advances in the research of prevention and treatment of postburn contractures of hand

作　　者：王康安[1] 伍国胜[1] 孙瑜[1] 夏照帆[1] 

机构地区：[1]第二军医大学长海医院烧伤外科,全军烧伤研究所,上海200433

出　　处：《中华烧伤杂志》2017年第1期58-61,共4页Chinese Journal of Burns

基　　金：上海市卫生系统优秀人才培养计划（XYQ2013079）;第二军医大学本科学员创新实践能力孵化基地项目（FH2015151）

摘　　要：烧伤深度在深Ⅱ度及以上时，往往会留下瘢痕、产生瘢痕挛缩。瘢痕挛缩是一种由纤维无序增生导致的纤维性疾病，常发生在伤及真皮层的烧/创伤之后[1]。临床上，瘢痕挛缩畸形是手烧伤后的常见并发症，Hop等[2]调查显示，烧伤后10年内由于瘢痕挛缩而行重建手术的第一大部位是手。美国烧伤协会认为手烧伤是一种严重的外伤，应该接受专业的治疗，以期减少增生性瘢痕和瘢痕挛缩等后遗症[3]。瘢痕挛缩会导致手的正常活动受限，而长期瘢痕挛缩易造成深部组织的继发性挛缩畸形，进一步加重肢体的功能障碍。Scar contracture deformity, which can lead to dysfunction of hand and low quality of life, is one of the common complication after hand burns. The prevention measures of scar contracture after hand burns include large skin grafting, prevention of infection, insistence on wearing pressure gloves, use of silicone sheets, wearing orthosis, accepting proper physical therapy, and early functional exercise. The primary treatments of postburn contractures of the hand are surgery, drugs, laser treatment, and rehabilitation therapy. Excision of scars, release of muscle, joints or bones, and soft tissue transplantation are the core of surgery. Laser treatment has a bright future but still needs to be further studied. Additionally, some novel treatments such as molecular targeted therapy, cell therapy, fat injection, and botulinum toxin injection will play important roles in prevention and treatment of postburn contractures in the future. The purpose of this article is to review the literature concerning postburn contractures of the hand, and summarize the present situation of prevention and treatment of such disease comprehensively.

关 键 词：烧伤 手 瘢痕 瘢痕挛缩 预防 治疗 

分 类 号：R644[医药卫生—外科学]