幼儿手掌严重烧伤后功能的重建与康复

Reconstruction of the Hand Function for the Infant Patients after Severe Burn of Palm

目的：探讨幼儿手掌严重烧伤后的治疗方案,降低畸形的发生率。方法：对18例幼儿手掌深度创面行延期切痂,清除肉芽坏死组织及其基底板,再行自体全厚皮分区完整移植,术后10～12 d拆线,出院后可塑夹板保持手部外形,弹性支架辅助功能锻炼等。结果：18例患儿手掌全厚植皮的成活率均〉95%;术后随访1～3年,仅2例出现小指轻度屈曲挛缩,其他患者手掌功能均恢复良好,发育未受明显影响。结论：手掌侧严重烧伤后行全厚皮分区完整移植、保证植皮的成功率及加以术后正确的功能锻炼是重建幼儿手掌功能,保证其正常发育并降低畸形发生率的关键。

Objective：To discuss the treatment for the infant patients with severe burn of palm in order to get the function and outlook reconstruction and decrease the occurrence of the deformity., Methods ： After the eschar and/or granulation having been cut off,the full-thickness skin was transplanted to the wound according to the function unit on palm. After 10-12 days,the dressing was exchanged at first time. When checking out,the patients were asked to do exercise and wear the elastic bandage for keeping the function and outlook. Results： Totally 18 cases were operated on by this way and the skin survival rate was over 95%. During a postoperative follow-up period of 1 to 3 years,the patients were satisfied with the function and outlook. Only 2 cases were subjected to re-operation because of the deformity of little finger. Conclusion： For the infant patients with severe burn of palm,the key for reconstruction of the function arid outlook,normal development and decreasing the rate of deformity is the full-thickness skin skingrafting according to the different areas on palm,higher survival rate of the grafted skin and postoperative function exercise.