不同类型颈部烧伤疤痕手术方法探讨

THE DISCUSSION ABOUT THE OPERATION METHODS OF DIFFERENT TYPES OF NECK BURN SCAR

  • 摘要: 目的 :观察不同手术方法 ,手术时间修复不同类型颈部烧伤疤痕挛缩畸形的临床疗效。方法 :对 12 3例不同类型颈部烧伤疤痕挛缩畸形施行 7种不同的手术方法 ,其中 41例儿童采用伤后 3种不同的手术时间修复 ,同时观察 44例不同厚度皮片移植术后半个月至 1年内 5个不同时期的皮片收缩率。结果 :安全简单的局部、邻近皮瓣修复效果最好 ;局部、邻近皮瓣辅以皮片移植修复优于单纯皮片移植 ;移植的皮片越厚 ,皮片术后收缩率越低 ;全、中厚皮片移植术后收缩率以 14d至半年尤其 3个月内为最高 ;儿童半年以上延迟手术会影响颜面部和脊柱的正常发育。结论 :早期选择合理的手术方法、手术时间与抗皮片挛缩治疗颈部烧伤疤痕挛缩畸形 ,能有效地防治疤痕挛缩 ,减轻 (少 )继发畸形的发生

     

    Abstract: Objective:To observe the clinical effect of repairing different kinds of neck cicatricial contracture with different operating methods at different time.Methods:123 patients with different kinds of neck cicatricial contracture have been operated in seven different ways.Among them,41 children were operated at 3 different time after they were injured.At the same time we observed the shrinkage rates of skin in 5 different stages of time from half a month to a year after different-thickness free skin grafting in 44 cases. Results:The local and adjacent skin flap repairing which is safe and simple can gain the best effect;the local and that with free skin grafting is better than simple free skin grafting.The thicker free skin we graft,the lower shrinkage rate we get; The shrinkage rates after full-thickness or intermediate-thickness free skin grafting,which is done within 14 days to 6 months and especially within 3 months after injury,are the highest.Postponent operations over 6 months can affect children's faces and the normal development of their spine bones.Conclusion:If we choose reasonable operation methods, operation time and measures against skin contracture early to treat neck burn scar contracture malformation, we can prevent and treat scar contracture effectively to diminish the occurrence of malformation.

     

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