PDF(Pubmed)
Abstract：
UNASSIGNED: Treating burn scar contractures remains challenging for reconstructive surgeons; no clear guidelines declare the optimal and most effective technique. We evaluated the efficacy of local flaps in treating patients with post-burn contractures.
UNASSIGNED: This retrospective study included 243 patients with post-burn contractures referred to Taleghani Hospital (Khuzestan, southwest Iran) for local flap reconstruction from 2011 to 2020. Patients\' demographic data, detailed descriptions of scars, surgical procedures, and flap outcomes were assessed. A plastic surgeon conducted all surgical procedures, the goals of which were to release the scar and cover the defect. Joint range of motion (ROM) (according to goniometric measurements), complications, need for second-stage surgery, and patient satisfaction were assessed.
UNASSIGNED: After scar release, 70.4% of joints were covered with a Z-plasty and similar local flaps, 26.1% with a Z-plasty plus skin grafts, and 3.5% with only skin grafts. The outcome after one year revealed a significant improvement in mean ROM (by 45.80% of the normal ROM; P< 0.001). The mean functional and aesthetic satisfaction scores were 9.45 and 7.61 out of 10, respectively. The complication rate was 10.82%: re-contracture occurred in 3.82%, flap tip necrosis in 1.27%, and partial flap necrosis in 0.31%.
UNASSIGNED: Simple local flaps such as the Z-plasty are safe and effective in covering the joint following post-burn contracture release. Due to the feasibility, minimal need for facilities, steep learning curve, acceptable functional and aesthetic outcomes, and low complication rate, we strongly recommend the Z-plasty for reconstructing burn contractures, particularly in LMICs.
UNASSIGNED: This retrospective study included 243 patients with post-burn contractures referred to Taleghani Hospital (Khuzestan, southwest Iran) for local flap reconstruction from 2011 to 2020. Patients\' demographic data, detailed descriptions of scars, surgical procedures, and flap outcomes were assessed. A plastic surgeon conducted all surgical procedures, the goals of which were to release the scar and cover the defect. Joint range of motion (ROM) (according to goniometric measurements), complications, need for second-stage surgery, and patient satisfaction were assessed.
UNASSIGNED: After scar release, 70.4% of joints were covered with a Z-plasty and similar local flaps, 26.1% with a Z-plasty plus skin grafts, and 3.5% with only skin grafts. The outcome after one year revealed a significant improvement in mean ROM (by 45.80% of the normal ROM; P< 0.001). The mean functional and aesthetic satisfaction scores were 9.45 and 7.61 out of 10, respectively. The complication rate was 10.82%: re-contracture occurred in 3.82%, flap tip necrosis in 1.27%, and partial flap necrosis in 0.31%.
UNASSIGNED: Simple local flaps such as the Z-plasty are safe and effective in covering the joint following post-burn contracture release. Due to the feasibility, minimal need for facilities, steep learning curve, acceptable functional and aesthetic outcomes, and low complication rate, we strongly recommend the Z-plasty for reconstructing burn contractures, particularly in LMICs.
摘要：
■治疗烧伤瘢痕挛缩对于重建外科医生来说仍然具有挑战性；没有明确的指南声明最佳和最有效的技术。我们评估了局部皮瓣治疗烧伤后挛缩患者的疗效。
■这项回顾性研究包括243例烧伤后挛缩患者，转诊至Taleghani医院（Khuzestan，伊朗西南部）用于2011年至2020年的局部皮瓣重建。患者人口统计数据，疤痕的详细描述，外科手术,并评估皮瓣结局.整形外科医生进行了所有的外科手术,其目标是释放疤痕并覆盖缺陷。关节运动范围（ROM）（根据测角测量），并发症,需要第二阶段手术，并评估患者满意度。
■疤痕释放后，70.4％的关节覆盖有Z型成形术和类似的局部皮瓣，26.1%采用Z-成形术加皮肤移植，只有3.5％的皮肤移植。一年后的结果显示平均ROM显着改善（正常ROM的45.80％；P<0.001）。平均功能和美学满意度得分分别为9.45和7.61，满分10分。并发症发生率为10.82%：再挛缩发生率为3.82%，皮瓣尖端坏死1.27%，局部皮瓣坏死占0.31%。
■烧伤后挛缩松解术后，简单的局部皮瓣如Z型成形术可安全有效地覆盖关节。由于可行性,对设施的需求最少，陡峭的学习曲线，可接受的功能和美学结果，并发症发生率低，我们强烈建议使用Z-成形术重建烧伤挛缩,特别是在低收入国家。
■这项回顾性研究包括243例烧伤后挛缩患者，转诊至Taleghani医院（Khuzestan，伊朗西南部）用于2011年至2020年的局部皮瓣重建。患者人口统计数据，疤痕的详细描述，外科手术,并评估皮瓣结局.整形外科医生进行了所有的外科手术,其目标是释放疤痕并覆盖缺陷。关节运动范围（ROM）（根据测角测量），并发症,需要第二阶段手术，并评估患者满意度。
■疤痕释放后，70.4％的关节覆盖有Z型成形术和类似的局部皮瓣，26.1%采用Z-成形术加皮肤移植，只有3.5％的皮肤移植。一年后的结果显示平均ROM显着改善（正常ROM的45.80％；P<0.001）。平均功能和美学满意度得分分别为9.45和7.61，满分10分。并发症发生率为10.82%：再挛缩发生率为3.82%，皮瓣尖端坏死1.27%，局部皮瓣坏死占0.31%。
■烧伤后挛缩松解术后，简单的局部皮瓣如Z型成形术可安全有效地覆盖关节。由于可行性,对设施的需求最少，陡峭的学习曲线，可接受的功能和美学结果，并发症发生率低，我们强烈建议使用Z-成形术重建烧伤挛缩,特别是在低收入国家。
