全厚皮片植皮修复在小儿手部瘢痕整形中的应用  

Application of Full Thickness Skin Graft in the Plastic Surgery for Children with Hand Scars

作　　者：马芸 马蕾[1] 邹继军[1] 汪玉霄 涂晶晶 MA Yun;MA Lei;ZOU Ji-jun;WANG Yu-xiao;TU Jing-jing(Department of Burns and Plastic Surgery,Children's Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu,China)

机构地区：[1]南京医科大学附属儿童医院烧伤整形科,江苏南京210000

出　　处：《中国美容医学》2021年第9期48-50,共3页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究全厚皮片植皮修复在小儿手部瘢痕整形中的应用效果。方法:回顾性分析2018年1月-2019年11月笔者医院收治的40例手部烧伤后瘢痕挛缩患儿的临床资料,根据手术方式的不同分为植皮组(22例,27只患手)和皮瓣修复组(18例,18只患手)。观察移植皮片/皮瓣成活情况,记录创面愈合时间、并发症发生率、术后疼痛情况、手部功能及形态恢复情况。结果:所有患儿均顺利完成手术。术后2周,植皮组25只患手移植皮片全部存活;1只出现伤口感染;2只出现再次瘢痕挛缩,行二次瘢痕切除植皮治疗。皮瓣修复组18只患手术后皮瓣全部成活,除2只出现伤口感染,无其他并发症发生。植皮组创面愈合时间及WBFS评分均低于皮瓣修复组,手部功能恢复优良率高于皮瓣修复组,差异均有统计学意义(P<0.05)。结论:全厚皮片植皮术在小儿手部瘢痕整形中应用价值较高,术后皮片成活率高,能有效改善患儿手部挛缩,促进手功能恢复。Objective To explore the effect of full-thickness skin graft in the plastic surgery of hand scar in children.Methods Clinical data of 40 children with scar contracture after burns who were treated at the hospital hospital during the period from January 2018 to November 2019 were retrospectively analyzed.The children were divided into the skin graft group(22 cases,27 hands)and the flap repair group(18 cases,18 hands)according to the surgical method.The survival status of skin grafts/flaps was observed.Wound healing time,the incidence of complications,postoperative pain,hand function and morphological recovery were recorded.Results All children underwent successful surgery.Two weeks after operation,all the grafts of 25 hands in the skin grafting group survived.One had wound infection.Two hands had scar contracture again and were treated with secondary scar resection and skin grafting.In the flap repair group,all 18 flaps survived after operation,and there were no other complications except two hands wound infection.The wound healing time and WBFS score in the skin graft group were lower than those in the flap repair group,and the excellent and good rate of hand function recovery was higher than that in the flap repair group,the differences were statistically significant(P<0.05).Conclusion Applying full thick skin graft in plastic surgery for children with hand scars can not only achieve high survival rate of skin flaps but also effectively relieve hand contracture and promote hand function recovery.

关 键 词：瘢痕畸形 整形修复 烧伤 全厚皮片植皮术 瘢痕切除术 

分 类 号：R619.6[医药卫生—外科学]