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Chinese Journal of Injury Repair and Wound Healing(Electronic Edition) ›› 2021, Vol. 16 ›› Issue (01): 34-38. doi: 10.3877/cma.j.issn.1673-9450.2021.01.006

Special Issue:

• Original Article • Previous Articles     Next Articles

Application of interlaced local skin flaps combined with autologous medium-thickness skin grafting in the repair of joint scar contracture

Wanfu Zhang1, Jing Xu1, Fei Han1, Xiaolong Hu1, Shaohui Li1, Zebing Yuan2, Dahai Hu1, Juntao Han1, Hao Guan1,()   

  1. 1. Department of Burns and Cutaneous Surgery, First Affiliated Hospital of Air Force Military Medical University, Xi′an 710032, China
    2. Department of Surgery, People′s Hospital of Langao County, Shanxi Province, Ankang 725400, China
  • Received:2020-12-25 Online:2021-02-01 Published:2021-02-01
  • Contact: Hao Guan

Abstract:

Objective

To explore the application effect of interlacing local skin flaps combined with autologous medium-thickness skin grafting in the repair of scar contractures in joints.

Methods

From January 2015 to January 2019, 80 cases of patients with scar contracture of the joint caused by burn were treated in the Department of Burns and Cutaneous Surgery of First Affiliated Hospital of Air Force Military Medical University. All patients were grouped according to the registration number, the single number was the control group, and the double number was observation group, 40 cases in each group. In both groups, the wounds were repaired after the scar was released. In the observation group, the spacing of the wound formed at the joint site was measured, and triangular flaps were designed in the opposite direction of the normal skin on both sides. After the flaps were removed, the flaps were rotated 90°, and the two flaps were staggered and conjuncted to completely cover the joint site. The upper and lower wounds formed after the peeled off of skin flap were covered with medium thickness skin grafts from the back or lateral thigh. The wounds in the control group were covered by large autologous medium thickness skin grafts directly on the back or lateral thigh according to the traditional treatment method. Follow-up for 6 months in the outpatient clinic or online, the clinical treatment effect of the 2 groups of patients were observed, the total effective rate, the postoperative anti-scar treatment time and patients satisfaction score of the 2 groups were calculated. Data were compared with t test and chi-square test.

Results

In the observation group, 28 cases were cured (70.0%), 11 cases were effective (27.5%), 1 case was ineffective (2.5%); 20 cases in the control group were cured (50.0%), 14 cases were effective (35.0%), and 6 cases were ineffective (15.0%), the total effective rate of the observation group was 97.5%, which was higher than 85.0% of the control group, and the differences was statistically significant (χ2=5.102, P<0.05). The postoperative anti-scar treatment time of the observation group was (41.93±8.16) d, which was lower than the control group [(64.17±11.35) d], and the appearance satisfaction score (91.34±13.75) points was higher than that of the control group [(79.33±9.04) points], the differences were statistically significance (t=14.742, 11.102; P<0.05).

Conclusions

Partitionspilt-thickness skin graft with local flap interlacing provides a better choice for the repair of scar contracture in joint parts. The postoperative area has good appearance, light contracture and good prognosis, which can be used as a beneficial supplement for the treatment of autologous medium-thickness skin grafts after the traditional joint scar release.

Key words: Cicatrix, Arthrogryposis, Surgical flaps, Skin graft

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