依创面定形厚断层皮片在全手背瘢痕整复中的应用

Application of shaped full thickness skin grafting for reconstruction of cicatricial back of hands

目的:研究皮肤移植重建手背的理想整形方法。方法:选择38例41只手背瘢痕。在局部肿胀麻醉下全层切除手背瘢痕并作关节畸形复位。用布片制作与创面相同形状和大小的取皮模板,以此制作定形厚断层皮片,植至手背创面。结果:41个定形皮片中36个皮片完全成活,术后6￣28个月随访28例31只手,手外形及功能良好,皮片色泽接近正常皮肤,无环形瘢痕形成。5个皮片有点状皮片坏死,后期随访结果也较好。所有病例未发生明显的环形瘢痕。结论:定形厚断层皮片移植是手背瘢痕整形的理想方法。

Objective To study an ideal skin grafting for hand-back reconstruction. Methods 38 cases of patients with hand back cicatrix were chosen for the study. Full thickness cicatrix was excised and deformtied joints were repositioned under local tumescent anesthesia. A cloth template was made to trace the wound of the hand. According to the template, a costumed full thickness skin graft was harvested free hand using an ultrasharp blade from the donor site and transplanted to the wound of the hand back. Results 36 skin grafts were completely survived and 28 grafts were followed up 6-28 months after operation. The superficial appearance and function of these hands gained ideal outcomes. There were spot-like skin loss in the other 5 grafts, but the long-run effects were also better. There were no any circumferential scar on the skin graft borders in all cases. Conclusion The shaped full thickness skin grafting is an ideal technique for the reconstruction of the hand back.