LIANG Liming 1 , CHAI Jiake 1 , JIA Xiaoming 1 , JING Sa 1 , WANG Yirong 2 , MENG Suyu 3 , LIU Tao 4
  • 1Department of Burns and Plastic Surgery, First Affiliated Hospital, General Hospital of Chinese PLA, Beijing, 100048, P.R.China;;
  • 2the Eighth Plastic Department of Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College;;
  • 3Department of Burns and Plastic Surgery, Fifth Hospital of Xingtai City;;
  • 4Department of Burns and Plastic Surgery, Wuhai People’s Hospital. Corresponding author: LIANG Liming, E-mail: lianglm304@yahoo.com.cn;
手背瘢痕; 预扩张全厚皮片; 创面修复
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Objective To investigate the feasibility of repairing secondary wounds after scar excision in patients with scar contracture in whole dorsum of the hands by expanded full-thickness skin grafts. Methods Between February 2008 and February 2011, 15 patients (19 hands) with scar contracture in whole dorsum of the hands were treated. There were 12 males (14 hands) and 3 females (5 hands), aged 18-43 years (mean, 28.6 years). The disease duration was 6-22 months (mean, 13.2 months). All cases complicated by different degrees of metacarpophalangeal joint extension deformity and interphalangeal joint flexion deformity. In one-stage operation, soft tissue expanders were implanted at donor sites, and the time of water injection was 4-5 months; in two-stage operation, scar was excised and secondary wound (14 cm × 9 cm-25 cm × 16 cm in size) was repaired with the expanded full-thickness skin grafts. Results After one-stage operation, the others had good blood supply except 1 case of skin necrosis in the center of expanded skin flap. After two-stage operation, the full-thickness skin grafts survived well in 18 hands; subepidermal effusion occurred in 1 hand, which was cured after changing dressing. The incisions at donor sites healed well in all cases. All patients were followed up 6-18 months (mean, 13.7 months). The grafts were excellent in color, texture, and elasticity, and no hypertrophic scar was observed at the edge and joint of the grafts. The hand function recovered well; the flexion and extension of wrist joint, metacarpophalangeal joint and interphalangeal joint were normal. Conclusion The expanded full-thickness skin graft is a suitable solution to repair effectively scar contracture in whole dorsum of the hands because it has good results in the cosmetic appearance and function recovery of the hands.

Citation： LIANG Liming,CHAI Jiake,JIA Xiaoming,JING Sa,WANG Yirong,MENG Suyu,LIU Tao. REPAIR OF SCAR CONTRACTURE IN WHOLE DORSUM OF HAND BY EXPANDED FULL-THICKNESS SKIN GRAFT. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(11): 1340-1343. doi: Copy