CAJ | 학술논문

目的探讨在重度关节瘢痕挛缩畸形治疗中,采用延期植皮术联合牵引术的效果.方法 2000年3月至2013年5月,临床治疗25例.对重度关节瘢痕挛缩畸形患者,一期行瘢痕切除松解术,术中保留关节部位的血管、神经、肌腱等重要组织,创面用脱细胞猪皮生物敷料覆盖、包扎.术后行关节部位持续皮牵引7～14d,待关节恢复到伸直位,即行二期自体皮移植术.结果 25例患者二期植皮术后2～3周创面一期愈合,皮片完全成活、色泽及弹性良好,关节屈伸基本正常.经3个月至11年的随访,除1例肩关节功能锻炼不积极,效果欠佳,其余均无瘢痕增生、挛缩,关节功能恢复满意.结论延期植皮术联合牵引术可有效提高皮片成活率、减轻瘢痕形成,关节功能得到良好恢复,提高了患者生活质量.
목적 탐토재중도관절반흔련축기형치료중,채용연기식피술연합견인술적효과.방법 2000년3월지2013년5월,림상치료25례.대중도관절반흔련축기형환자,일기행반흔절제송해술,술중보류관절부위적혈관、신경、기건등중요조직,창면용탈세포저피생물부료복개、포찰.술후행관절부위지속피견인7～14d,대관절회복도신직위,즉행이기자체피이식술.결과 25례환자이기식피술후2～3주창면일기유합,피편완전성활、색택급탄성량호,관절굴신기본정상.경3개월지11년적수방,제1례견관절공능단련불적겁,효과흠가,기여균무반흔증생、련축,관절공능회복만의.결론 연기식피술연합견인술가유효제고피편성활솔、감경반흔형성,관절공능득도량호회복,제고료환자생활질량.
Objective To investigate the effect of delayed skin grafting combined traction in severe joint cicatricial contracture.Methods At the first stage,the joint cicatricial contracture was released completely with protection of vessels,nerves and tendons.The wound was covered with allogenetic skin or biomaterials.After skin traction for 7-14 days,the joint could reach the extension position.Then the skin graft was performed on the wound.25 cases were treated from Mar.2000 to May.2013.Results Primary healing was achieved at the second stage in all the cases.The skin graft had a satisfactory color and elasticity.Joint function was normal.All the patients were followed up for 3 months to 11 years with no hypertrophic scar and contraction relapse,except for one case who didn' t have enough active exercise on shoulder joint.Conclusion Delayed skin grafting combined traction can effectively increase the skin graft survival rate and improve the joint function recovery.