扩张瘢痕皮片移植修复关节部位瘢痕挛缩畸形  

Repair of Joint Scar Contracture Deformity with Expanded Scar Skin Graft

作　　者：袁家德[1] 孙丽双[1] 柯家祥[1] 李宁[1] 朱志军[1] 边曦[1] YUAN Jia-de;SUN Li-shuang;KE Jia-xiang;LI Ning;ZHU Zhi-jun;BIAN Xi(Department of Burn and Plastic Surgery,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China)

机构地区：[1]青岛市立医院烧伤整形科,山东青岛266011

出　　处：《中国美容医学》2021年第5期38-40,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨应用背部扩张表浅瘢痕皮片移植修复特重度烧伤后关节部位瘢痕挛缩畸形效果。方法:选择背部有大片表浅瘢痕,四肢有瘢痕增生挛缩的特重度烧伤后患者6例。一期手术将扩张器置入背部表浅瘢痕处,按照每植皮1cm^(2)注水7~9ml的比例注水扩张背部表浅瘢痕;二期取出扩张器,切取扩张的瘢痕皮片,去除纤维囊层后游离移植到瘢痕挛缩松解的继发创面。结果:所移植的扩张瘢痕皮片有4例完全成活,2例大部分成活,畸形改善明显,关节功能基本恢复。结论:该方法在自体皮源欠缺的情况下,充分利用表浅瘢痕皮片修复瘢痕畸形、重建关节功能,为特重度烧伤后瘢痕挛缩畸形的修复提供了一种安全有效的手术方法。Objective To explore the application of dilated superficial scars on the back to treat scar contractures in the joints after severe burns.Methods Six patients with severe burns with large superficial scars on the back and scar hyperplasia contractures on the extremities were selected.In the first stage of operation,the dilator was placed into the superficial scar of the back,and the superficial scar of the back was expanded by injecting 7-9 ml of water per 1 cm^(2) of skin graft.At the second stage,the dilator was removed,the expanded scar skin was cut,and the fibrous capsule was removed and then the free graft was carried to the secondary wound surface of the loosened scar contracture of the limbs.Results 4 cases of the expanded scar skin graft survived completely,2 cases mostly survived.The deformity improved obviously,and the joint function basically recovered.Conclusion This method fully utilizes superficial scar skin to repair scar deformity and reconstruct joint function in the case of scarce autogenous skin source,and provides a safe and effective surgical method for scar repair in patients with severe burn.

关 键 词：瘢痕 挛缩畸形 皮肤软组织扩张术 扩张瘢痕皮片 关节部位 烧伤 移植修复 

分 类 号：R619.6[医药卫生—外科学]