矩形皮瓣联合肌腱延长术治疗小儿手掌瘢痕挛缩  

Application of rectangular flap combined with tendon lengthening in the treatment of palmar scar contracture in children

作　　者：肖明[1] 袁继龙[1] 高婧囡 石杰[1] XIAO Ming;YUAN Ji-long;GAO Jing-nan;SHI Jie(Department of Plastic Surgery,The People’s Hospital of Liaoning Province,Shenyang 110016,China)

机构地区：[1]辽宁省人民医院整形美容外科,辽宁沈阳110016

出　　处：《中国美容整形外科杂志》2021年第2期109-110,I0007,共3页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的探讨利用矩形皮瓣联合肌腱延长术治疗小儿手掌瘢痕挛缩的可行性及优势。方法自2014年9月至2019年9月,辽宁省人民医院整形美容外科对26例(31侧)手掌瘢痕挛缩的患儿行手术治疗及功能性修复。以矩形皮瓣修复蹼状畸形,以肌腱延长术修复严重的屈曲畸形,其余瘢痕松解部位以游离皮片移植或邻近皮瓣转移的方式修复,术后配合功能锻炼。结果本组26例患儿皮瓣均成活良好无大面积坏死及血液循环障碍发生。3例植皮边缘出现局部坏死的轻微并发症,经换药治疗,未对最终手术效果造成影响。分别在术后2周、6个月进行随访,其后每年随访1次,外观及功能良好。结论矩形皮瓣联合肌腱延长术治疗小儿手掌瘢痕挛缩,配合规范的术后功能锻炼可取得良好效果。Objective To explore the feasibility and advantages of rectangular flap combined with tendon lengthening in the treatment of palmar scar contracture in children.To provide reference for clinical application.Methods From September 2014 to 2019,26 children with palmar scar contracture(31 sides)underwent surgical treatment and function repair in the Department of Plastic Surgery of People’s Hospital of Liaoning Province.The webbed deformities were repaired by rectangular flaps and the severe flexion deformities were repaired by tendon lengthening.The rest scars release sites were repaired by free skin grafts or adjacent flaps.Functional exercises are required after operation.Results All skin flaps survived well,and no necrosis and blood circulation disorder occurred.Local necrosis of skin graft edges occurred in 3 patients and cured after dressing change.These minor complications had no impact on final surgical results.The follow-up was conducted at 2 weeks and 6 months after operation,and then once every year.The appearance and function was good.Conclusion Treatment of palmar scar contracture in children by rectangular flap combined with tendon lengthening and postoperative functional exercises can obtain good results.

关 键 词：瘢痕挛缩 肌腱延长 矩形皮瓣 整形修复 

分 类 号：R726.2[医药卫生—儿科]