菱形皮瓣成形术在烧伤后瘢痕挛缩中的应用效果分析  

Analysis of the application effect of diamond shaped skin flap in scar contracture after burn injury

作　　者：张方 李丹 崔庆伟 ZHANG Fang;LI Dan;CUI Qingwei(Department of Burns and Plastic Surgery,Huaihai Hospital Affiliated to Xuzhou Medical University,71st Army Group Hospital,Jiangsu Province,221004,China;Department of Traditional Chinese Medicine Rehabilitation and Physiotherapy,Huaihai Hospital Affiliated to Xuzhou Medical University,71st Army Group Hospital,Jiangsu Province,221004,China)

机构地区：[1]徐州医科大学附属淮海医院陆军第七十一集团军医院烧伤整形科,江苏徐州221004 [2]徐州医科大学附属淮海医院陆军第七十一集团军医院中医康复理疗科,江苏徐州221004

出　　处：《中国医疗美容》2024年第12期61-65,共5页China Medical Cosmetology

摘　　要：目的探讨菱形皮瓣成形术在烧伤后瘢痕挛缩中的应用效果。方法选取2018年10月至2023年10月徐州医科大学附属淮海医院收治的98例烧伤后瘢痕挛缩患者进行回顾性分析,所有患者均采取皮瓣修复治疗,游离皮瓣组49例患者采取常规游离皮瓣移植术,菱形皮瓣组49例患者采取菱形皮瓣成形术。术后分别于6个月、1年对患者进行门诊复查随访,对比其皮瓣成活率与瘢痕复发率,受区瘢痕情况,并发症发生率及满意度,生活质量水平。结果菱形皮瓣组皮瓣成活率高于游离皮瓣组,瘢痕复发率低于游离皮瓣组(P<0.05);术后6个月、1年两组患者VSS评分均降低,菱形皮瓣组低于游离皮瓣组(P<0.05);菱形皮瓣组术后并发症发生率低于游离皮瓣组,满意度高于游离皮瓣组(P<0.05);术后6个月、1年两组患者36项健康调查简表(summary table of 36 health surveys,SF-36)评分均升高,菱形皮瓣组高于游离皮瓣组(P<0.05)。结论与常规游离皮瓣移植术相比,对烧伤后瘢痕挛缩患者采取菱形皮瓣成形术可提升皮瓣存活率,降低瘢痕复发率,改善受区瘢痕情况,同时可降低患者术后并发症发生率,提升患者满意度,改善其生活质量。Objective To explore the application effect of diamond shaped skin flap in scar contracture after burns.Methods A retrospective analysis was conducted on 98 patients with burn scar contracture admitted to uaihai Hospital Affifiliated to Xuzhou Medical University from October 2018 to October 2023.All patients underwent flap repair treatment,with 49 patients in the free flap group receiving conventional free flap transplantation and 49 patients in the diamond flap group receiving diamond flap reconstruction.After surgery,outpatient follow-up visits were conducted at 6 months and 1 year to compare the survival rate of skin flaps and scar recurrence rate,scar condition in the affected area,incidence and satisfaction of complications,and quality of life level.Results The survival rate of the diamond shaped flap group was higher than that of the free flap group,and the scar recurrence rate was lower than that of the free flap group(P<0.05);At 6 months and 1 year after surgery,the VSS scores of both groups of patients decreased,with the diamond flap group lower than the free flap group(P<0.05);The incidence of postoperative complications in the diamond shaped flap group was lower than that in the free flap group,and the satisfaction rate was higher than that in the free flap group(P<0.05);At 6 months and 1 year after surgery,both groups of patients showed an increase in the Summary Table of 36 Health Surveys(SF-36)scores,with the diamond flap group having higher scores than the free flap group(P<0.05).Conclusions Compared with conventional free skin flap transplantation,diamond shaped skin flap reconstruction can improve the survival rate of skin flaps,reduce scar recurrence rate,improve scar conditions in the recipient area,and reduce the incidence of postoperative complications in patients with burn scar contracture.Patient satisfaction is higher and can further improve the quality of life of patients.

关 键 词：游离皮瓣移植术 菱形皮瓣成形术 瘢痕挛缩 皮瓣成活率 满意度 生活质量 

分 类 号：R47[医药卫生—护理学]