EFFECTIVENESS OF DIFFERENT FLAPS FOR REPAIR OF SEVERE PALM SCAR CONTRACTURE DEFORMITY_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

PANGMengru , XIAOHaitao , WANGHuaisheng , LIUXiaoxue ,  CHENJunjie ,  CENYing

Department of Burn and Plastic Surgery, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China;

Corresponding author：

CHENJunjie, Email: cjjemail@163.com; CENYing, Email: cenying835@163.com

Keywords：

Scar contracture; Soft tissue defect; Free flap; Pedicled flap; Island flap

DOI：

10.7507/1002-1892.20160075

Video：

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Objective To evaluate the effectiveness of different flaps for repair of severe palm scar contracture deformity. Methods Between February 2013 and March 2015, thirteen cases of severe palm scar contracture deformity were included in the retrospective review. There were 10 males and 3 females, aged from 14 to 54 years (mean, 39 years). The causes included burn in 9 cases, hot-crush injury in 2 cases, chemical burn in 1 case, and electric burn in 1 case. The disease duration was 6 months to 6 years (mean, 2.3 years). After excising scar, releasing contracture and interrupting adherent muscle and tendon, the soft tissues and skin defects ranged from 6.0 cm×4.5 cm to 17.0 cm×7.5 cm. The radial artery retrograde island flap was used in 2 cases, the pedicled abdominal flaps in 4 cases, the thoracodorsal artery perforator flap in 2 cases, the anterolateral thigh flap in 1 case, and the scapular free flap in 4 cases. The size of flap ranged from 6.0 cm×4.5 cm to 17.0 cm×7.5 cm. Results All flaps survived well. Venous thrombosis of the pedicled abdominal flaps occurred in 1 case, which was cured after dressing change, and healing by first intention was obtained in the others. The mean follow-up time was 8 months (range, 6-14 months). Eight cases underwent operation for 1-3 times to make the flap thinner. At last follow-up, the flaps had good color, and the results of appearance and function were satisfactory. Conclusion Severe palm scar contracture deformity can be effectively repaired by proper application of different flaps.

Citation： PANGMengru, XIAOHaitao, WANGHuaisheng, LIUXiaoxue, CHENJunjie, CENYing. EFFECTIVENESS OF DIFFERENT FLAPS FOR REPAIR OF SEVERE PALM SCAR CONTRACTURE DEFORMITY. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(3): 382-384. doi: 10.7507/1002-1892.20160075 Copy

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16.	吴学强, 刘会仁, 刘德群.股前外侧皮瓣应用研究的进展.中华显微外科杂志, 2011, 34(1): 83-85.
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1. 李军, 陈积民.手部瘢痕挛缩畸形治疗及功能恢复的评价.现代康复, 1999, 3(7): 821-821.
2. 王炜.整形外科学.杭州:浙江科学技术出版社, 1999: 100-101, 176-178, 1214-1240, 1520.
3. 梁好, 李风景, 牛军.腹部带蒂皮瓣修复治疗手部软组织缺损.实用医药杂志, 2011, 28(1): 45.
4. 李孝新, 曾锁林, 黄平, 等.带蒂髂腹股沟皮瓣修复手部软组织缺损20例.西部医学, 2011, 23(3): 521-522.
5. Wei Fu-Chan, Mardini Samir. Flaps and Reconstructive Surgery.北京:人民卫生出版社, 2011: 247-260.
6. 王东超.桡动脉皮支逆行皮瓣的应用解剖研究.青海医学院学报, 2010, 31(2): 109-111.
7. 王琳.桡动脉逆行岛状皮瓣治疗手掌瘢痕挛缩.淮海医药, 2002, 20(2): 124-125.
8. 邓昭元, 张仰, 黄思责.桡动脉逆行岛状皮瓣的临床应用.中国烧伤创疡杂志, 2004, 16(2): 141-142.
9. 张涤生.显微外科的历史回顾和展望.中华显微外科杂志, 2006, 29(1): 1-3.
10. 孙奎, 张颖.肩胛皮瓣和小腿后侧皮瓣联合修复足部缺损.中华整形外科杂志, 2005, 21(6): 475.
11. 臧成五, 赵睿, 张航, 等.游离肩胛皮瓣修复足踝部创面的临床应用.中华显微外科杂志, 2014, 37(3): 297-298.
12. 陈星隆, 高伟阳, 洪建军, 等.游离肩胛皮瓣修复手腕部软组织缺损.中华手外科杂志, 2004, 20(2): 77-78.
13. 刘宁, 李小兵, 张静琦.直接携带游离肩胛皮瓣修复难治性创面.中华烧伤杂志, 2010, 26(3): 228-229.
14. 张静琦, 刘宁, 曹建功.肩胛皮瓣在修复皮肤软组织缺损中的应用.中国实用美容整形外科杂志, 2005, 16(4): 219-220.
15. 卢仕良, 谢伟勇, 陶国责.肩胛皮瓣在四肢组织缺损美学修复中的应用.武警医学, 2011, 22(8): 679-684.
16. 吴学强, 刘会仁, 刘德群.股前外侧皮瓣应用研究的进展.中华显微外科杂志, 2011, 34(1): 83-85.
17. 王爱国, 邱勇.股前外侧皮瓣远侧肌皮穿支的解剖学研究与临床应用.中华骨科杂志, 2011, 31(3): 255-259.
18. 舒伟, 夏德林.股前外侧皮瓣的解剖及应用进展.西南国防医药, 2015, 25(3): 340-342.
19. 何齐, 高碧奇, 李会晓.游离股前外侧皮瓣修复四肢软组织缺损.实用手外科杂志, 2010, 24(1): 65-77.
20. 刘国强, 刘泽, 吴文元, 等.股前外侧皮瓣修复软组织缺损的临床应用.中国煤炭工业医学杂志, 2008, 11(8): 1198-1199.
21. 杨大平, 唐茂林, Steve F. Morris, 等.胸背动脉穿支皮瓣的解剖研究和临床应用.中国临床解剖学杂志, 2006, 24(2): 240-242.

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Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF DIFFERENT FLAPS FOR REPAIR OF SEVERE PALM SCAR CONTRACTURE DEFORMITY

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