特大面积深度烧伤晚期整形31例临床分析

目的探讨特大面积深度烧伤晚期瘢痕畸形的整形外科修复方法。方法 1994年1月-2008年5月共收治31例烧伤面积超过80%TBSA(Ⅲ度面积均超过50%TBSA)、治愈后多部位出现瘢痕挛缩、严重畸形的患者,采用软组织扩张、毛发种植、皮片、皮瓣或瘢痕瓣、复合皮、同基因异体皮等多种方法修复。结果本组患者在全部手术完成后外观功能得到明显改善,随访6个月～5年,BI评分优12例(39%),良16例(52%),中3例(10%),日常生活均能自理,无一例长期卧床需人照顾。结论通过综合康复及手术整形等多种方法治疗,特大面积烧伤患者瘢痕畸形已能得到良好改善,大部分患者外观功能恢复满意。

Plastic surgical treatment for scar deformity after major burn

Objective To explore the surgical restorative procedure for scar deformity after major burn.Methods We treated 31 cases with more than 80% TBSA burn surface area.Multi-part scar contracture and deformity occurred in the 31 cases after the treatment during January 1994 to May 2008.Soft tissue expansion,hair implantation,and transplantation with free skin,skin flap, scar flap,composite skin and syngenic skin allograft were used to treat the scar contracture and deformity.Results The 31 cases were followed up 6 months to 5 years after operation.According to BI scoring,restoration was excellent in 12 cases (39% ) ,good in 16 cases (52% ) and effective in 3 cases (10% ) .All the patients were able to take care of themselves in daily life and did not need others to help them.Conclusion Scar deformity after major burn can be improved by multiple treatments such as combined rehabilitation and plastic surgery.The restoration of appearance and function is good in most patients.