小儿深度烧伤后瘢痕畸形的预防及治疗

目的:探讨小儿深度烧伤后瘢痕畸形的预防及治疗方法。方法:以40例深度烧伤患儿为研究对象,其中对照组17例为不接受早期手术,出院后未能进行规范的瘢痕康复治疗和功能锻炼的患儿;治疗组23例进行早期切削痂植皮手术,出院后临床医生跟踪指导患儿家属进行持续规范的瘢痕康复治疗和功能锻炼。以温哥华瘢痕量表为标准分别在出院当日和出院后1、3、6、12个月对患儿进行瘢痕测评。结果:治疗组患儿在出院当日及出院后不同时间瘢痕的色泽、血管分布、厚度和柔软度温哥华瘢痕量表评分均明显优于对照组(P<0.01)。结论:早期手术及持续规范的瘢痕康复治疗和功能锻炼能有效预防和减轻小儿深度烧伤后的瘢痕畸形和功能障碍。

Prevention and treatment of the scar deformity in pediatric deep burn

Objective:To explore the prevention and treatment methods of the scar deformity in pediatric deep burn. Methods:Forty children with deep burn were divided into the control group ( 17 cases ) and treatment group ( 23 cases ) . The control group were not treated with early operation,and standard scar rehabilitation and functional exercise after discharge from hospital,the treatment group cases were treated with early escharectomy with dermatoplasty, and continuously standard scar rehabilitation and functional exercise guided by clinicians after discharge from hospital. The scars in two groups were evaluated using Vancouver Scar Scale on the day of discharge and in 1,3,6 and 12 months after discharge from hospital. Results:The Vancouver Scar Scale scores in the color,vascular distribution,thickness and flexibility of scar in treatment group were significantly better than those in control group in different time points after discharge from hospital(P<0. 01). Conclusions:Early operation,continuously standard scar rehabilitation and functional exercise can effectively prevent and reduce the scar deformity and dysfunction in pediatric deep burn.