手瘢痕挛缩畸形整形疗效分析

Analysis of the Plastic Effects on Cicatrical Contracture Deformities of Hands

目的:探讨手瘢痕挛缩畸形手术整形临床效果。方法:2012年3月-2015年10月收治47例(73手)手部瘢痕挛缩畸形患者。手术切除部分或全部瘢痕组织,松解瘢痕挛缩,自体全厚皮移植修复创面。条索状瘢痕、指蹼及虎口处松解瘢痕挛缩后,用V-Y、Z形皮瓣、五瓣等局部皮瓣开大虎口、加深指蹼。结果:7只手因小指或示指指间关节瘢痕挛缩重,无法完全矫正,余手部畸形完全矫正。随访2~24个月,5只手因皮片挛缩,再次出现手瘢痕挛缩畸形。余手部功能恢复良好,皮瓣及皮片质地软,弹性良好。结论:局部皮瓣及全厚皮移植修复手瘢痕挛缩畸形临床效果好;为防止瘢痕挛缩重致畸形难以完全矫正,需早期手术。

Objective To probe into the clinical effects of plastic surgery on cicatrical contracture deformities of hands. Methods 47 patients（73 hands involved） suffering from cicatrical contracture deformities of hands were received and treated from March 2012 to October 2015. Scars were cut partially or wholly to loose cicatrical contracture. The wounds were cured with full-thickness skin grafting from patients themselves. After loosing the cicatrical contracture in web-space and Hukou, flaps like V-Y and Z were used to widen Hukou and deepen web-space. Results The wounds in 7 hands were not cured perfectly due to the serious cicatrical contracture at the joints of little fingers and forefingers, the rest being cured thoroughly. 2-24 months of follow-up showed that cicatrical contracture reoccurred in 5 hands because of flap contracture and the others recovered with soft and stretchy flaps. Conclusion Regional flap and full-thickness skin grafting had good clinical effects on cicatrical contracture deformities of hands. But early surgery was required to prevent cicatrical contracture from worsening and thus,to cure it completely.