并趾分离术后发生瘢痕疙瘩相关因素的回顾性研究

A Retrospective Study on Keloid Formation after Syndactyly Release

目的分析术前并连足趾形态、并连程度、手术方式、术后切口愈合等情况与术后瘢痕疙瘩发生的相关性,以探讨并趾分离术后发生瘢痕疙瘩的可能原因。方法回顾性分析2011年1月至2016年1月在我科行并趾分离术的253例患儿的临床资料,调查患儿术前足趾形态、并连程度、手术方式、术后切口愈合情况和术后瘢痕情况,分析这些情况与术后瘢痕疙瘩发生的相关性。结果术后发生瘢痕疙瘩共8例,均为并连足趾肥大且完全性并趾者,术中均有植皮。并连足趾肥大的患儿术后瘢痕疙瘩的发生率显著高于并趾但足趾形态正常的患儿,组间差异有统计学意义(P<0.05);完全性并趾术后瘢痕疙瘩的发生率高于不完全性并趾患儿,差异显著(P<0.05);术中植皮的患儿瘢痕疙瘩发生率明显高于未植皮患儿,亦存在显著差异(P<0.05);切口一期愈合与延迟愈合的患儿间,瘢痕疙瘩发生率无明显差异(P>0.05)。结论并趾分离术后瘢痕疙瘩的发生,与术前并连足趾肥大存在高度相关性,与完全性并趾和术中植皮亦有相关性,并连足趾肥大可能是导致术后发生瘢痕疙瘩的主要原因。

Objective To explore the causes of keloid after syndactyly release by analyzing the correlation of preoperative toe forms, the degree of joining, surgical procedure, postoperative incision healing with postoperative keloid. Methods From January 2011 to January 2016, 253 children with syndactyly release were retrospectively reviewed to investigate the preoperative toe forms, the degree of joining, surgical procedure, postoperative incision healing and postoperative keloid. SPSS 22.0 software was used for the statistical analysis of the relationship of preoperative toe forms, the degree of joining, surgical procedure, postoperative incision healing with postoperative keloid. Results Eight children occurred keloid after syndactyly release. These patients all had pachydactyly, complete syndactyly, and all of them received skin-grafting. After operation, the difference between groups was statistically significant in pachydactyly, the degree of joining and skin-grafting（P〈0.05）. There was no statistical significant difference between groups in wound healing（P〈0.05）. Conclusion There is highly correlation between pachydactyly and keloid formation after syndactyly release, pachydactyly may be the main cause of keloid formation after syndactyly release.Meanwhile, there are relevance on complete syndactyly and skin-grafting.