瘢痕切除联合中厚皮移植整形手术对深Ⅱ度烧伤愈合后瘢痕畸形患者关节功能的疗效  

Scar excision with thick skin graft in the plastic surgery in patients with deep scar deformity after Ⅱ degree burns healing the curative effect of joint function

作　　者：樊昌伟 韩志新 李振超[1] 牛大伟 余建功 FAN chang-wei;HAN zhi-xin;LI zhen-chao;NIU da-wei;YU jian-gong(Department of burn orthopedics,anyang people's hospital,Henan Province,455000,China)

机构地区：[1]安阳市人民医院烧伤整形科

出　　处：《中国医疗美容》2019年第9期43-45,49,共4页China Medical Cosmetology

摘　　要：目的探讨深Ⅱ度烧伤愈合后瘢痕畸形患者行瘢痕切除联合中厚皮移植术治疗的临床效果。方法:择取2015年1月-2018年12月我院17例颈部深Ⅱ度烧伤愈合后瘢痕畸形患者,瘢痕挛缩畸形累及关节处皮肤,造成关节不同程度活动度下降,接受瘢痕切除联合中厚皮移植术,术后功能锻炼。评价手术疗效,统计并发症,观察受累关节活动度改善情况,统计患者满意度。结果:患者术后未见皮瓣感染、血肿、撕脱等并发症,随访6个月治疗有效率100%,患者满意度94.12%。术后,患者颈活动度较前明显改善后伸(38.5±3.7)°,左侧屈(42.5±2.8)°,右侧屈(41.9±3.0)°,左旋(67.5±7.1)°,右旋(67.1±6.4)°,各项指标均优于术前(P <0.05)。结论:深Ⅱ度烧伤愈合后瘢痕畸形采用瘢痕切除联合中厚皮移植手术治疗效果确切,患者并发症少,满意度高,可有效改善关节活动度,促进功能恢复,值得临床使用推广。Objective To study the deep Ⅱ degree of burn scar deformity after healig joint scar resection in patients with the clinical effect of thick skin transplantation therapy. Methods From January 2015 to December 2018, 17 patients with scar deformity af ter healing of deep seconddegree neck burns in our hospital, with scar contracture deformity involving the skin of the joint, resulting in decreased joint mobility of different degrees, were selected to receive scar resection combined with mediumthickness skin transplantati on, and postoperative functional exercise.The surgical efficacy was evaluated, complications were counted, range of motion of the affec ted joint was observed, and patient satisfaction was counted.Results No complications such as flaps infection, hematoma and avulsion were found in the patients. The effective rate was 100% and the satisfaction rate was 94.12%.Postoperatively, the cervical mobility of th e patients was significantly improved compared with that before surgery, including posterior extension (38.5±3.7)°, left flexion (42.5±2 .8)°, right flexion (41.9±3.0)°, left rotation (67.5±7.1)°, and right rotation (67.1±6.4)°, all of which were better than that before surger y (P < 0.05).Conclusion Deep Ⅱ degree of burn scar deformity after healing using scar excision with thick skin transplantation in th e surgical treatment effect is exact, fewer complications, patients'satisfaction is high, can effectively improve the joint activity, p romote the functional recovery, worthy of clinical use.

关 键 词：深Ⅱ度烧伤 瘢痕畸形 瘢痕切除 中厚皮移植术 关节功能 

分 类 号：R622[医药卫生—整形外科]