METHODS: A cross-sectional study was performed among patients with deep hand burns requiring a modified Colson flap between 2018 and 2021. Outcomes included functional and cosmetic assessment of the hand through a quality-of-life questionnaire, a sensitivity scale and a scar assessment scale.
RESULTS: During this period, 7 patients were operated on using our technique. One patient was lost to follow-up; 7 patients with a median age of 44 years were included, with a total of 10 burned hands. The burns were thermal in 5 out of 7 cases and the coverage concerned the whole hand in 50% of the cases. The flaps all received cannula defatting. The median time to flap weaning was 23 days (20 to 30 days). The median follow-up was 16 months. One case required remote flap weaning. The median POSAS (Patient and Observer Scar Assessment Scale) per patient was 4 and 2 per observer. The median BMRCSS (British Medical Research Council Sensory Scale) was 122. One case had recovered S2 sensitivity, the other cases had S3 or S4 sensitivity.
CONCLUSIONS: Immediate defatting is one of the factors in tegumental quality allowing rapid functional recovery of the hand. The cannula defatting technique does not appear to require additional defatting time. The use of the liposuction cannula allows a one-step, homogeneous, and easier defatting, with a lower risk of devascularization.
方法:在2018年至2021年间,对需要改良Colson皮瓣的深度手部烧伤患者进行了横断面研究。结果包括通过生活质量问卷对手部进行功能和美容评估,敏感度量表和疤痕评估量表。
结果:在此期间,使用我们的技术对7例患者进行了手术。一名患者失访;包括7名中位年龄为44岁的患者,共有10只手烧伤。7例中有5例烧伤是热烧伤,50%的烧伤涉及整个手。皮瓣都接受了套管脱脂。皮瓣断奶的中位时间为23天(20至30天)。中位随访时间为16个月。一个案例需要远程襟翼断线。每位患者的中位POSAS(患者和观察者疤痕评估量表)分别为4和2。BMRCSS(英国医学研究委员会感觉量表)的中位数为122。一个病例恢复了S2敏感性,其他病例具有S3或S4敏感性.
结论:立即脱脂是使手部功能快速恢复的被膜质量因素之一。套管脱脂技术似乎不需要额外的脱脂时间。吸脂套管的使用允许一步,同质,更容易脱脂,血运重建的风险较低。