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蹼状瘢痕挛缩常见于烧伤后期,易发生于指蹼、颈前、腋窝、肘部及足背等功能部位,其矫正方法较多。利用蹼状挛缩瘢痕周边组织的松动性,通过总Z角达135°、实际主轴的延长率约为180%的六瓣Z成形术,矫治刀例不同部位的蹼状瘢痕挛缩,经1~2年随访,疗效稳定,功能及外观满意。六瓣Z成形术,手术设计简单,勿需游离皮片移植,术后瘢痕不易再挛缩,外观满意。 相似文献
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目的:采用指蹼矩形瓣联合双指侧三角瓣整复指蹼瘢痕挛缩畸形。方法:2003年1月以来,采用指蹼矩形瓣联合双指侧三角瓣整复指蹼瘢痕挛缩畸形者47例,其中男性32例,女性15例;多个指蹼瘢痕挛缩畸形者42例,总计指蹼瘢痕挛缩畸形139例次;烧伤面积最大者95%,最小者2%;年龄最大者54岁,年龄最小者2岁;烧伤至整复间隔时间最长者10年,最短者5个月,平均2年。结果:139例次指蹼瘢痕挛缩畸形,经指蹼矩形瓣联合双指侧三角瓣转移修复后,各指蹼瘢痕挛缩彻底松解,经6个月~5年随访,效果十分满意。结论:采用指蹼矩形瓣联合双指侧三角瓣,指蹼瘢痕瓣血运良好,术后早期即可开始功能锻炼,远期观察未见挛缩,有利于掌指关节及指蹼的功能恢复,是指蹼瘢痕挛缩畸形修复可供选择的一种有价值的方法。 相似文献
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自 1996年以来 ,笔者利用九瓣法对 46例烧伤后蹼状瘢痕患者施行了整复手术。其中蹼状瘢痕发生在腋窝 16例 ,窝 9例 ,颈前 6例 ,踝关节 4例 ,肘关节 5例 ,腕关节 2例 ,虎口 4例。全部病例的蹼状瘢痕畸形都得到了最大限度的整复 ,关节功能恢复正常。其中 45例单纯使用九瓣法就达到了良好的整复效果 ,1例在使用九瓣法同时辅以植皮修复也达到了治疗目的。所有患者对整复效果都很满意。1 手术方法 1.1 设计 在五瓣法设计的基础上 ,延长其主轴线 ,并反向延长五瓣法设计中两侧Z成形之斜臂 ,并于延长之主轴线两端各画一平行于五瓣法两端Z成… 相似文献
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自1996年以来,笔者利用九瓣法对46例烧伤后蹼状瘢痕患者施行了整复手术.其中蹼状瘢痕发生在腋窝16例,腘窝9例,颈前6例,踝关节4例,肘关节5例,腕关节2例,虎口4例.全部病例的蹼状瘢痕畸形都得到了最大限度的整复,关节功能恢复正常.其中45例单纯使用九瓣法就达到了良好的整复效果,1例在使用九瓣法同时辅以植皮修复也达到了治疗目的.所有患者对整复效果都很满意. 相似文献
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Adnan G. Gelidan 《International wound journal》2023,20(8):3185-3190
Surgical procedures performed during neonatal period or childhood that result in vertical midline, transverse left upper quadrant, or central upper abdominal scars create significant psychological concerns in adulthood. Various surgical techniques correct depressed scars, including scar revision, Z- or W-plasty flaps, sub-incision tunnelling, fat grafting, and autologous or alloplastic dermal grafting. This article describes a novel technique for repairing depressed abdominal scars using hybrid double-dermal flaps. We included patients with psychosocial concerns who underwent abdominal scar revision because of wedding plans. Hybrid local de-epithelised dermal flaps were used to correct the depression of the abdominal scar. Superior and inferior skin flaps, medial and lateral to the depressed scar, were de-epithelised for 2 to 3 cm and sutured using the vest-over-pants technique with 2/0 nylon permanent sutures. Six female patients who want to marry were included in this study. Depressed abdominal scars were successfully fixed using hybrid double-dermal flaps, either from the superior-inferior aspect for transverse scars or from the medial-lateral aspect for vertical scars. No postoperative complications were noted, and the patients were satisfied with the outcomes. De-epithelialised double-dermal flaps in the vest-over-pants technique are an effective and valuable surgical technique for correcting depressed scars. 相似文献
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采用双蒂瘢痕组织皮瓣治疗关节部位的瘢痕挛缩畸形 总被引:1,自引:0,他引:1
目的:介绍双蒂瘢痕组织皮瓣治疗关节部位的瘢痕挛缩。方法:2004年10月~2007年初,利用双蒂瘢痕组织皮瓣共治疗了5例关节部位瘢痕组织挛缩畸形的患者,1例为肘关节,2例为腋窝,2例为膝关节,手术均在伤后半年以上进行。术后随访3个月~1年,平均随访时间为6个月。结果:对所有患者,术后效果都是可以接受的。双蒂瘢痕皮瓣的优点是手术简单,皮瓣坏死可能性低,肢体固定时间短,瘢痕挛缩复发的可能性低。结论:这种双蒂瘢痕组织皮瓣可作为关节部位瘢痕挛缩治疗的选择方法之一。 相似文献
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下腹部岛状皮瓣修复会阴部瘢痕畸形15例 总被引:2,自引:0,他引:2
目的:总结下腹部岛状皮瓣修复会阴部瘢痕畸形的临床经验。方法:回顾性分析下腹部岛状皮瓣修复会阴部瘢痕挛缩畸形15例患者的临床资料,单纯采用以旋髂浅动静脉为蒂形成的皮瓣3例、单纯采用腹壁浅动静脉为蒂的皮瓣5例,两组血管均包括在内的皮瓣7例。结果:所有皮瓣均存活,局部畸形纠正,患者满意,经随访6~48个月,皮瓣色泽良好,质地柔软,排尿排便功能恢复正常,髋部活动无明显受限。结论:下腹部岛状皮瓣转移术可提高会阴部瘢痕畸形的修复质量。 相似文献
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Hassanpour SE Motamed S Ghazisaidi M 《Burns : journal of the International Society for Burn Injuries》2007,33(2):236-240
Many surgical techniques exist for reconstruction of burn scar contracture of the antecubital fossa, such as Z plasty, VY plasty, lateral arm flap, and medial arm flap. Another option is direct release of the scar contracture and skin graft of the defect area, which requires prolonged splinting and risk of graft failure. Additionally, in the areas with exposed tendons or vessels, we cannot use grafts. Recurrence of contracture remains another drawback of this treatment, in this article we present a new, simple alternative method for treatment of these cases. In this clinical trial we introduce a new technique of bipedicle flap from scar tissue for coverage of the antecubital fossa with skin grafting of the proximal and distal parts of this bipedicle flap. From July 2002 to July 2005 we used this flap in 12 patients and efficacy and versatility of this flap was studied. Seven patients were female and 5 were male with mean age of 23.7 years. The mean time between burn and our reconstructive operation was 3.2 years. The mean surface area of antecubital burn scar tissue was 77.5%. Mean extension lag before operation was 66.5 degrees , mean extension lag during operation was 4.5 degrees and after operation was 5.4 degrees . Minor complication was observed in two cases with necrosis of the flap margin. Mean follow-up period was 17 months and the appearance of operated site in antecubital fossa was acceptable in all patients. The advantage of this bipedicle flap is its simple surgical technique. The risk of flap necrosis is negligible and it is a reliable flap. Splinting time is short and the risk of recurrence of contracture with this technique is minimal. 相似文献
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Chung-Ho Feng Jui-Yung YangShiow-Shuh Chuang Chun-Yuan HuangYen-Chang Hsiao Chao-Yi Lai 《Burns : journal of the International Society for Burn Injuries》2010
Introduction
Dynamic and static complex scar contractures after burn commonly cause tendon adhesion, deep adipose tissue stiffness and further limitation of major joints motion. Skin autografting or locoregional flaps are not adequate reconstructive options, because of the easy recurrence and limitation of donor sites. Therefore, free perforator flaps are playing increasing role in reconstruction of complex scar contractures.Patients and methods
The free medial thigh perforator (MTP) flap is an addition to the reconstructive armamentarium and is particularly useful since the medial thigh is commonly spared in burn injury. Between December 2001 and October 2005, eight patients with severe post-burn scar contractures received free MTP flaps treatment in the Linkou Burn Center. The free MTP flap harvest was modified to enhance its reliability and versatility. Flap sizes ranged from 5 × 15 cm to 8 × 24 cm. The follow-up period was from 12 to 26 months. Flap harvest is rapid, averaging 37.8 min.Results
The significantly improved range of motion of the contracture joints approximated to normal activity at 6–22-month follow-up (p < 0.05). No free major MTP flap complication was noted, except for mild marginal necrosis in one case.Conclusion
The free MTP flap with new modified harvest is a good choice for dynamic an static complex scar contractures of major joints, due to short harvesting time and few variations of the pedicle. However, thick skin paddle was considered in secondary hand reconstruction. 相似文献19.