To observe the effect of the combined use of pressure gloves, finger web compression starps and foam silicone gel sheeting in preventing hypertrophic contracture of finger web after surgery in children with cicatricial syndactyly.

A retrospective analysis was conducted on the clinical data of 32 cicatricial syndactyly children who met the inclusion and exclusion criteria, treated in the Department of Burns and Plastic Surgery, Kunming Children′s Hospital from December 2020 to January 2023, involving a total of 51 cicatricial syndactyly finger webs. Based on the methods of preventing hypertrophic contracture of finger web after surgery, the patients were divided into conventional group and observation group. The observation group comprised 16 patients with 24 cicatricial syndactyly finger webs, while the conventional group consisted of 16 patients with 27 cicatricial syndactyly finger webs. All patients underwent cicatricial syndactyly correction surgery under general anesthesia to reconstruct the webs. After the sutures in surgical area were removed, the conventional group applied silicone gel externally on the reconstructed webs and wore pressure gloves and web compression straps. The observation group used foam silicone gel sheeting on the reconstructed webs and also wore pressure gloves and web compression straps. The total active movement (TAM) developed by the American Society for Surgery of the Hand was used to evaluate the function of the affected finger in the two groups at 12 months after surgery. The modified Withey syndactyly correction score was employed to assess the recurrence of cicatricial syndactyly at 12 months after surgery in the two groups. The Vancouver scar scale (VSS) was utilized to evaluate the scar condition of the two groups at 3, 6, and 12 months after surgery. Adverse reactions during treatment were recorded. Bonferroni correction, repeated measures analysis of variance, χ² test, t test, and Fisher′s exact test were performed on the data.

At 12 months after surgery, the excellent and good rate of TAM in the reconstructed webs of the observation group was 95.8%, while that of the conventional group was 77.8%, there was no significant difference between the two groups (P>0.05). The recurrence rate of cicatricial syndactyly in the reconstructed webs of the observation group was 0%, which was lower than 22.2% of the conventional group, and the difference was statistically significant (P<0.05). At 3 months after surgery, the VSS score of the reconstructed web scars in the observation group was (2.54±1.37), while that of the conventional group was (2.41±1.59), showing no significant difference (t=16.322, P>0.05). At 6 and 12 months after surgery, the VSS scores of the reconstructed web scars in the observation group were (4.02±1.95) and (2.96±0.68) respectively, both lower than (5.34±1.29) and (4.30±0.94) of the conventional group, with significant differences (t=5.783, 9.486; P<0.05). During treatment, the incidence rates of maceration and rash in the reconstructed webs of the observation group were 12.5% and 12.5% respectively, while those of the conventional group were 7.4% and 7.4%, showing no significant difference (P>0.05). The incidence rates of pain and ulceration in the reconstructed webs of the observation group were 4.2% and 0%, which were lower than 29.6% and 22.2% of the conventional group, with significant differences (P<0.05).

The early combined application of pressure gloves, finger web compression straps and foam silicone gel sheeting after surgery in children with cicatricial syndactyly can effectively prevent the hypertrophic contracture of reconstructed web and the recurrence of syndactyly, and reduce the adverse reaction of treatment.