瘢痕内松解治疗颈部瘢痕挛缩

Release within scar for treatment of scar contracture of the neck

目的:探讨瘢痕内松解治疗颈部瘢痕挛缩的可行性。方法:从2005年3月到2008年11月,应用自制的推刀对收治的6例Ⅱ度颈部瘢痕挛缩畸形的患者行瘢痕内切开,松解挛缩,术后应用颈部弹力套压迫防止瘢痕增生、继发挛缩。结果:头颈部活动度6例中4例明显改善,2例好转。平均随诊8个月(3～20个月)未见挛缩复发。颌颈部曲线自然,颏颈角清晰。结论:瘢痕内松解可增加瘢痕挛缩畸形颈部的活动度。对于轻度颈部瘢痕挛缩可改善外观和功能,患者满意率高。

Objective To investigate the feasibility of the treatment of scar contracture of the neck by release within scar using a modified scalpel. Methods Between March 2007 and November 2008, 6 patients with type Ⅱ scar contracture of the neck underwent the procedure of release within scar using a tailor-made scalpel. Postoperatively, an elastic cuff was used to cover the neck to matain a persistent pressure on the surface of the scar for more than six monthes to prevent scar hyperplasia and secondary contracture. Results Postopratively, the movement of the neck was improved significantly in 4 cases and moderately in the other 2 patients. Within 8-month （3 to 20 months） follow-up, there was no contracture recurred. All patients kept a natural cervical curve anda clear mandible-cervical angle. Conclusions Release within scar could improve the movement of the scar contracted neck. If patients selected appropriately, a good result and higher satisfactory rate could be achieved.