皮下组织蒂菱形皮瓣成形术对烧伤后瘢痕挛缩患者的疗效观察
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摘要
目的探究皮下组织蒂菱形皮瓣成形术治疗烧伤后瘢痕挛缩患者的临床疗效。方法选取我院66例烧伤后瘢痕挛缩患者,行皮下组织蒂菱形皮瓣成形术治疗。统计本组皮瓣成活率、瘢痕挛缩复发率、手术前后生活质量综合评定问卷(GQOL-74)评分、手术满意度。结果本组33皮瓣成活,皮瓣成活率为100.00%(33/33),1例瘢痕挛缩复发,瘢痕挛缩复发率为3.03%(1/33);本组术后12个月GQOL-74评分高于术前、术后6个月,术后6个月GQOL-74评分高于术前(P <0.05)。结论皮下组织蒂菱形皮瓣成形术治疗烧伤后瘢痕挛缩患者,瘢痕挛缩复发率低,手术满意度高,能有效改善患者生活质量。
Objective To investigate the clinical efficacy of subcutaneous tissue pedicled rhomboplasty in the treatment of patients with scar contracture after burn. Methods Sixty-six patients with scar contracture after burn were selected and divided into two groups according to the surgical method, with 33 cases in each group. The free group was treated with free skin grafting, and the subcutaneous group was treated with subcutaneous tissue pedicled flap. The survival rate of the two groups of flaps, the recurrence rate of scar contracture, the quality of life comprehensive assessment questionnaire(GQOL-74) score, and the satisfaction of surgery were compared. Results In this group, 33 flaps survived, the survival rate of flaps was 100.00%(33/33), 1 case of recurrence of scar contracture, and the recurrence rate of scar contracture was 3.03%(1/33). The GQOL-74 score of this group was 12 months after operation. GQOL-74 scores were higher than those before surgery and 6 months after surgery, and 6 months after operation(P < 0.05).Conclusion Subcutaneous tissue pedicled rhomboplasty for the treatment of scar contracture after burn, the recurrence rate of scar contracture is low, and the satisfaction of surgery is high, which can effectively improve the quality of life of patients.
Objective To investigate the clinical efficacy of subcutaneous tissue pedicled rhomboplasty in the treatment of patients with scar contracture after burn. Methods Sixty-six patients with scar contracture after burn were selected and divided into two groups according to the surgical method, with 33 cases in each group. The free group was treated with free skin grafting, and the subcutaneous group was treated with subcutaneous tissue pedicled flap. The survival rate of the two groups of flaps, the recurrence rate of scar contracture, the quality of life comprehensive assessment questionnaire(GQOL-74) score, and the satisfaction of surgery were compared. Results In this group, 33 flaps survived, the survival rate of flaps was 100.00%(33/33), 1 case of recurrence of scar contracture, and the recurrence rate of scar contracture was 3.03%(1/33). The GQOL-74 score of this group was 12 months after operation. GQOL-74 scores were higher than those before surgery and 6 months after surgery, and 6 months after operation(P < 0.05).Conclusion Subcutaneous tissue pedicled rhomboplasty for the treatment of scar contracture after burn, the recurrence rate of scar contracture is low, and the satisfaction of surgery is high, which can effectively improve the quality of life of patients.
引文
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[12]卫东.邻近扩张皮瓣修复手部烫伤后瘢痕挛缩畸形的临床观察[J].实用临床医药杂志,2016,20(19):108-110.DOI:10.7619/jcmp.201619036.
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[14]周芳,成智.皮下蒂菱形、星形皮瓣在挛缩性瘢痕治疗中的应用[J].中华整形外科杂志,2013,29(3):229-231.DOI:10.3760/cma.j.issn.1009-4598.2013.03.022.
[15]乔向坤,邢宇龙,宋素革.皮下组织蒂菱形皮瓣成形术治疗烧伤后瘢痕挛缩的疗效观察及术后近中期随访研究[J].中国医疗美容,2017,7(10):23-25.DOI:10.19593/j.issn.2095-0721.2017.10.009
[2]Dong X L,Yu D.Application of Cicatricial Contracture Release Principles in Muscular Torticollis Treatment[J].Aesthetic Plast Surg,2013,37(5):950-955.DOI:10.1007/s00266-013-0122-4.
[3]陈彦名,唐举玉,谢松林,等.腓肠内侧动脉穿支皮瓣游离移植修复重度虎口瘢痕挛缩[J].中华手外科杂志,2017,33(3):190.DOI:10.3760/cma.j.issn.1009-4598.2017.S1.011
[4]Zhuang Y Q,Xiong H T,Fu Q,et al.Functional pectoralis minor myocutaneous flap transplantation for reconstruction of thumb opposition:An anatomic study with clinical applications[J].Asian J Surg,2018,41(4):389-395.DOI:10.1016/j.asjsur.2017.05.004.
[5]代晓强,李红梅.三种整复方法在乳腺癌根治术后并发腋腔瘢痕挛缩的疗效比较[J].医学临床研究,2017,34(2):309-311.DOI:10.3969/j.issn.1671-7171.2017.02.033.
[6]Denadai R,Saadhossne R,Raposoamaral C E.Simulationbased rhomboid flap skills training during medical education:comparing low-and high-fidelity bench models[J].J Craniofac Surg,2014,25(6):2 134-2 138.DOI:10.1097/SCS.0000000000001094.
[7]刘建云,刘军.皮下组织蒂皮瓣修复足底皮肤软组织缺损五例[J].中华烧伤杂志,2015,31(1):66-67.DOI:10.3760/cma.j.issn.1009-2587.2015.01.018.
[8]江水华,郭开今,项洁,等.玻璃酸钠关节腔注射治疗对膝骨关节炎患者膝关节功能、日常活动能力以及生活质量的影响[J].现代生物医学进展,2017,17(35):6 860-6 864.DOI:10.13241/j.cnki.pmb.2017.35.014.
[9]何平,张琦.不同治疗方法对颈部瘢痕挛缩患者生活质量的影响[J].医学临床研究,2017,34(7):1 351-1 353.DOI:10.3969/j.issn.1671-7171.2017.07.034.
[10]Kesan K,Kothari P,Gupta R,et al.Closure of Large Meningomyelocele Wound Defects with Subcutaneous Based Pedicle Flap with Bilateral V-Y Advancement:Our Experience and Review of Literature[J].Eur J Pediatr Surg,2014,25(2):189-194.DOI:10.1055/s-0034-1368796.
[11]Han,Bing,Fan,et al.Faciocervical Reconstruction Using a Large Expanded Forehead Island Flap Grafted Using a Microsurgical Technique for Burned Cicatricial Contracture Correction[J].JCraniofac Surg,2018,29(7):1 848-1 850.DOI:10.1097/SCS.0000000000004647.
[12]卫东.邻近扩张皮瓣修复手部烫伤后瘢痕挛缩畸形的临床观察[J].实用临床医药杂志,2016,20(19):108-110.DOI:10.7619/jcmp.201619036.
[13]刘继松,宋德恒,章祥洲,等.人工真皮修复儿童四肢烧伤后瘢痕挛缩的临床效果[J].蚌埠医学院学报,2017,42(10):1374-1376.DOI:10.13898/j.cnki.issn.1000-2200.2017.10.025.
[14]周芳,成智.皮下蒂菱形、星形皮瓣在挛缩性瘢痕治疗中的应用[J].中华整形外科杂志,2013,29(3):229-231.DOI:10.3760/cma.j.issn.1009-4598.2013.03.022.
[15]乔向坤,邢宇龙,宋素革.皮下组织蒂菱形皮瓣成形术治疗烧伤后瘢痕挛缩的疗效观察及术后近中期随访研究[J].中国医疗美容,2017,7(10):23-25.DOI:10.19593/j.issn.2095-0721.2017.10.009