额部扩张皮瓣修复术对颈部烧伤瘢痕患者颈部活动度及美观度的影响

The Effect of Forehead Expansion Flap Repair on Neck Mobility and Aesthetics in Patients with Neck Burn Scars

目的探讨额部扩张皮瓣修复术对颈部烧伤瘢痕患者颈部活动度及美观度的影响.方法选取2019年5月—2022年5月新疆石河子大学第一附属医院收治的70例颈部烧伤瘢痕患者为研究对象,随机将其分为对照组与观察组.对照组(n=35)采用胸三角扩张皮瓣修复术,观察组(n=35)采用额部扩张皮瓣修复术,对比两组的颈部活动度及美观度.结果治疗后,两组左侧屈、右侧屈、左旋、右旋、前屈、后伸活动度分别为(41.48±5.51)°、(45.28±5.44)°、(50.56±5.39)°、(50.14±6.63)°、(46.77±5.15)°、(32.77±3.90)°,均大于对照组的(25.24±3.17)°、(25.12±3.18)°、(18.73±2.21)°、(17.85±2.26)°、(13.48±1.54)°、(12.54±1.21)°,但组间比较差异无统计学意义(P>0.05);观察组整体美学效果、供应区美观效果、皮瓣质地色泽、皮瓣回缩程度的满意率均高于对照组,组间差异有统计学意义(P<0.05);观察组温哥华瘢痕量表中瘢痕颜色、痛感、厚度、血管、瘙痒及柔软度评分均低于对照组,组间差异有统计学意义(P<0.05).结论额部扩张皮瓣修复术对颈部烧伤瘢痕患者颈部活动度及美观度具有提高作用,且能改善瘢痕状况.

Objective To explore the effect of forehead expansion flap repair on neck mobility and aesthetics in patients with neck burn scars.Methods From May 2019 to May 2022,70 patients with neck burn scar in the First Affiliated Hospital of Shihezi University in Xinjiang were selected and randomly divided into control group and observation group.The control group consisted of 35 cases who underwent thoracic triangle expansion flap repair,while the observation group consisted of 35 cases who underwent forehead expansion flap repair.The neck mobility and aesthetics of the two groups were compared.Results After treatment,the left flexion,right flexion,left rotation,right rotation,forward flexion and backward extension of the two groups were(41.48±5.51)°,(45.28±5.44)°,(50.56±5.39)°,(50.14±6.63)°,(46.77±5.15)°,(32.77±3.90)°,respectively.They were larger than(25.24±3.17)°,(25.12±3.18)°,(18.73±2.21)°,(17.85±2.26)°,(13.48±1.54)°,(12.54±1.21)°of the control group,but there was no significant difference between the two groups(P>0.05);the satisfaction rate of the observation group with overall aesthetic effect,supply area aesthetic effect,skin flap texture and color,and skin flap retraction degree was higher than that of the control group,and the difference was statistically significant(P<0.05);the Vancouver Scar Scale(mVSS)in the observation group showed significantly lower scores for scar color,pain,thickness,blood vessels,itching,and softness compared to the control group(P<0.05).Conclusion The forehead expansion flap repair surgery has an improved effect on the neck mobility and aesthetics of patients with neck burn scars,and can also improve the scar condition.