侧胸部Ⅱ度烧伤愈合后任意超长皮瓣修复肘关节瘢痕挛缩畸形的研究

Reconstructing the elbow scar contracture with super-long randomize flaps from healed skin after II degree burn injury on lateral chest

目的:探讨应用任意超长皮瓣修复大面积烧伤患者肘关节瘢痕挛缩畸形的修复方法。方法:2008年1月～2010年12月,我科临床工作中应用侧胸部II度烧伤创面愈合后皮肤形成的随意超长皮瓣修复肘关节瘢痕挛缩畸形20例,其中男13例,女7例,年龄5～47岁,皮瓣长宽比均达3～4∶1的范围内。结果:20例患者的超长皮瓣全部成活,其中有2例皮瓣远端1/4坏死,经换药等处理后伤口愈合,并有轻度的增生性瘢痕形成,其他均I期愈合,且术后均得到较好的关节功能修复。随访1月～3年,1例患者1年后肘关节再次出现轻度的挛缩,经过功能锻炼,关节活动基本不受限,其他患者肘关节功能恢复良好。结论:侧胸部II度烧伤创面愈合后皮肤形成的超长皮瓣是修复肘关节瘢痕挛缩畸形的一种有效途径。

Objective To investigate a suitable way to reconstruct the elbow scar contractures for patients with great area burn. Methods From January 2008 to December 2010, 20 patients with the elbow scar contractures were treated, including 13 males and 7females with an age range of 5-47 years. The deformities of scar contractures in the elbow were reconstructed with the super-long randomize flaps from healing skin after II degree burn wound in the side chest. The flaps length width ratio is up to 3N4：1. Results 20 super-long randomize flaps survived completely by the first intention except 2 flaps, which margin 1/4 necrosed and healed with dressing changes ,and then from mild hyperplastic scar. All patients were followed up 1 month to 3 years. All patients gained a good functional recovery except 1 patient, whose elbow appeared mild contracture one year after operation. Through functional exercise,the patient received a good functional recovery. Conclusion The super-long randomize flaps from healing skin after II degree burn wound in the lateral chest or abdomen is a good alternative method to reconstruct scar contractures in the elbow