腹股沟皮瓣修复在手及前臂皮肤烧伤瘢痕患者中的应用
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摘要
目的观察腹股沟皮瓣修复在手及前臂皮肤烧伤瘢痕患者中的应用效果。方法选取我院2016年9月至2018年8月收治手及前臂皮肤烧伤瘢痕患者86例。随机数字表法分为观察组和对照组,各43例。对照组采用股前外侧皮瓣修复术治疗,观察组实施腹股沟皮瓣修复术治疗。统计对比两组皮瓣感染、皮瓣存活、皮瓣断蒂时间及术前、术后6个月温哥华瘢痕评定量表(Vancouverscarscale,VSS)、上肢功能指数(Upper extremity functional index,UEFI)评分变化。结果观察组皮瓣存活率(97.67%)较对照组(79.07%)高,且皮瓣感染发生率(4.65%)较对照组(30.23%)低(P <0.05);观察组皮瓣断蒂时间为(21.35±4.58)d,较对照组(27.53±5.17)d短(P <0.05);术后6个月与对照组比较,观察组VSS、UEFI量表评分较高(P <0.05)。结论腹股沟皮瓣修复术应用于手及前臂皮肤烧伤瘢痕患者,可降低皮瓣感染风险,缩短断蒂时间,提高皮瓣成活率及改善上肢功能。
Objective To observe the effect of inguinal flap repair on patients with hand and forearm skin burn scars. Methods 86 patients with hand and forearm skin burn scars were treated from September 2016 to August 2018 in our hospital. The random number table method was used to divide them into observation group and control group, with 43 cases in each group. The control group was treated with anterolateral thigh flap repair, and the observation group was treated with inguinal flap repair. Statistical comparison of two groups of flap infection, flap survival, flap dysfunction time and preoperative and postoperative 6 months Vancouver vulture rating scale(VSS), Upper extremity functional index(UEFI) score change.Results The survival rate of the flaps(97.67%) was higher than that of the control group(79.07%), and the incidence of flap infection(4.65%) was lower than that of the control group(30.23%)(P < 0.05)..The time was(21.35±4.58)d, which was shorter than that of the control group(27.53±5.17)d(P < 0.05).. Compared with the control group at 6 months after operation, the scores of VSS and UEFI were higher in the observation group(P < 0.05)..Conclusion Inguinal flap repair is applied to patients with hand and forearm skin burn scars, which can reduce the risk of flap infection, shorten the time of stagnation, improve the survival rate of flap and the satisfaction of treatment.
Objective To observe the effect of inguinal flap repair on patients with hand and forearm skin burn scars. Methods 86 patients with hand and forearm skin burn scars were treated from September 2016 to August 2018 in our hospital. The random number table method was used to divide them into observation group and control group, with 43 cases in each group. The control group was treated with anterolateral thigh flap repair, and the observation group was treated with inguinal flap repair. Statistical comparison of two groups of flap infection, flap survival, flap dysfunction time and preoperative and postoperative 6 months Vancouver vulture rating scale(VSS), Upper extremity functional index(UEFI) score change.Results The survival rate of the flaps(97.67%) was higher than that of the control group(79.07%), and the incidence of flap infection(4.65%) was lower than that of the control group(30.23%)(P < 0.05)..The time was(21.35±4.58)d, which was shorter than that of the control group(27.53±5.17)d(P < 0.05).. Compared with the control group at 6 months after operation, the scores of VSS and UEFI were higher in the observation group(P < 0.05)..Conclusion Inguinal flap repair is applied to patients with hand and forearm skin burn scars, which can reduce the risk of flap infection, shorten the time of stagnation, improve the survival rate of flap and the satisfaction of treatment.
引文
[1]张琪,张斌,关颖,等.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的疗效观察[J].航空航天医学杂志,2016,27(11):1378-1379.DOI:10.3969/j.issn.2095-1434.2016.11.022.
[2]Amouzou K S,Berny N,El H A,et al.The pedicled groin flap in resurfacing hand burn scar release and other injuries:a five-case series report and review of the literature[J].Ann Burns Fire Disasters,2017,30(1):57-61.
[3]曾锐彬,刘勇胜,李赞芳,等.分析皮瓣修复治疗在手以及前臂皮肤烧伤瘢痕治疗中的应用[J].数理医药学杂志,2017,30(8):1175-1176.DOI:10.3969/j.issn.1004-4337.2017.08.032.
[4]Kotick J D,Sandelin R S,Klein R D.Deep Inferior Epigastric Perforator Free Flaps for Use in Complicated Groin Wound Repair:A Case Report of Severe Groin Scar Contracture and Review of Pedicled and Free Flaps in Groin Wound Repair[J].J Hand Microsurg,2017,9(2):101-106.DOI:10.1055/s-0037-1604475.
[5]蔡浩,李文婷,林姗,等.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的效果分析[J].临床医学,2018,36(4):12-14.DOI:CNKI:SUN:EBED.0.2018-04-004.
[6]Chen B,Song H,Gao Q,et al.Pedicled fasciocutaneous flaps for correcting scar contracture in pediatric patients-a retrospective study of 22 cases[J].J Pediatr Surg,2016,51(7):1207-1215.DOI:10.1016/j.jpedsurg.2015.12.006.
[7]林联铎,蔡晓燕.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的疗效观察[J].中国医药科学,2014,4(4):179-181.DOI:10.3969/j.issn.1674-4721.2011.24.008.
[8]孙广峰,魏在荣,金文虎,等.扩张髂腹股沟超薄皮瓣修复手部前臂瘢痕[J].中华手外科杂志,2015,31(1):53-55.DOI:10.3760/cma.j.issn.1005-054X.2015.01.020.
[9]Lee J W,Jang Y C,Oh S J.Esthetic and Functional Reconstruction for Burn Deformities of the Lower Lip and Chin With Free Radial Forearm Flap[J].Annals of Plastic Surgery,2006,56(4):384-386.DOI:10.1097/01.sap.0000200283.03650.e3.
[10]田枫.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的疗效观察[J].中国现代药物应用,2015,9(4):18-19.DOI:10.14164/j.cnki.cn11-5581/r.2015.04.012.
[11]单琦,耿英豪.腹股沟皮瓣移植术在上肢深度烧伤创面整形中的应用效果[J].中国医疗美容,2017,7(1):15-17.DOI:10.13764/j.cnki.lcsy.2016.10.011.
[12]Giordano L,Bondi S,Ferrario F,et al.Radial forearm free flap surgery:a modified skin-closure technique improving donor-site aesthetic appearance.[J].Acta Otorhinolaryngologica Italica,2012,32(3):158-163.DOI:doi:10.2310/7070.2012.00014.
[13]Song B,Jin J,Liu Y,et al.Prefabricated Expanded Free Lower Abdominal Skin Flap for Cutaneous Coverage of a Forearm Burn Wound Defect[J].Aesthetic Plastic Surgery,2013,37(5):956-959.DOI:10.3969/j.issn.2095-1434.2016.11.022.
[14]陈德明,徐晓阳,王蔚.皮瓣修复术在手外伤软组织缺损治疗中的应用价值[J].河北医药,2014,36(22):3464-3465.DOI:10.3969/j.issn.1002-7386.2014.22.043.
[15]袁兆能.腹股沟皮瓣移植术在上肢深度烧伤创面整形中的应用效果[J].实用临床医学,2016,17(10):31-32.DOI:10.13764/j.cnki.lcsy.2016.10.011.
[2]Amouzou K S,Berny N,El H A,et al.The pedicled groin flap in resurfacing hand burn scar release and other injuries:a five-case series report and review of the literature[J].Ann Burns Fire Disasters,2017,30(1):57-61.
[3]曾锐彬,刘勇胜,李赞芳,等.分析皮瓣修复治疗在手以及前臂皮肤烧伤瘢痕治疗中的应用[J].数理医药学杂志,2017,30(8):1175-1176.DOI:10.3969/j.issn.1004-4337.2017.08.032.
[4]Kotick J D,Sandelin R S,Klein R D.Deep Inferior Epigastric Perforator Free Flaps for Use in Complicated Groin Wound Repair:A Case Report of Severe Groin Scar Contracture and Review of Pedicled and Free Flaps in Groin Wound Repair[J].J Hand Microsurg,2017,9(2):101-106.DOI:10.1055/s-0037-1604475.
[5]蔡浩,李文婷,林姗,等.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的效果分析[J].临床医学,2018,36(4):12-14.DOI:CNKI:SUN:EBED.0.2018-04-004.
[6]Chen B,Song H,Gao Q,et al.Pedicled fasciocutaneous flaps for correcting scar contracture in pediatric patients-a retrospective study of 22 cases[J].J Pediatr Surg,2016,51(7):1207-1215.DOI:10.1016/j.jpedsurg.2015.12.006.
[7]林联铎,蔡晓燕.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的疗效观察[J].中国医药科学,2014,4(4):179-181.DOI:10.3969/j.issn.1674-4721.2011.24.008.
[8]孙广峰,魏在荣,金文虎,等.扩张髂腹股沟超薄皮瓣修复手部前臂瘢痕[J].中华手外科杂志,2015,31(1):53-55.DOI:10.3760/cma.j.issn.1005-054X.2015.01.020.
[9]Lee J W,Jang Y C,Oh S J.Esthetic and Functional Reconstruction for Burn Deformities of the Lower Lip and Chin With Free Radial Forearm Flap[J].Annals of Plastic Surgery,2006,56(4):384-386.DOI:10.1097/01.sap.0000200283.03650.e3.
[10]田枫.皮瓣修复治疗手及前臂皮肤烧伤瘢痕的疗效观察[J].中国现代药物应用,2015,9(4):18-19.DOI:10.14164/j.cnki.cn11-5581/r.2015.04.012.
[11]单琦,耿英豪.腹股沟皮瓣移植术在上肢深度烧伤创面整形中的应用效果[J].中国医疗美容,2017,7(1):15-17.DOI:10.13764/j.cnki.lcsy.2016.10.011.
[12]Giordano L,Bondi S,Ferrario F,et al.Radial forearm free flap surgery:a modified skin-closure technique improving donor-site aesthetic appearance.[J].Acta Otorhinolaryngologica Italica,2012,32(3):158-163.DOI:doi:10.2310/7070.2012.00014.
[13]Song B,Jin J,Liu Y,et al.Prefabricated Expanded Free Lower Abdominal Skin Flap for Cutaneous Coverage of a Forearm Burn Wound Defect[J].Aesthetic Plastic Surgery,2013,37(5):956-959.DOI:10.3969/j.issn.2095-1434.2016.11.022.
[14]陈德明,徐晓阳,王蔚.皮瓣修复术在手外伤软组织缺损治疗中的应用价值[J].河北医药,2014,36(22):3464-3465.DOI:10.3969/j.issn.1002-7386.2014.22.043.
[15]袁兆能.腹股沟皮瓣移植术在上肢深度烧伤创面整形中的应用效果[J].实用临床医学,2016,17(10):31-32.DOI:10.13764/j.cnki.lcsy.2016.10.011.