CAJ | 학술논문

目的探讨手部烧伤后瘢痕增生的治疗方法.方法对2007～2011年收治的手部烧伤后瘢痕增生患者46例78只手,采用瘢痕切除皮片移植、挛缩松解、克氏针固定38只手,瘢痕切除局部皮瓣转移18只手,瘢痕切除植皮18只手,瘢痕切除腹部远位扩张皮瓣转移4只手,术区半年内均给予弹力套加压疗法、外用硅凝胶制剂及功能训练治疗,52只手部切口给予蜡疗药物导入治疗,26只手部切口有瘢痕增生,给予瘢痕内药物注射治疗,治疗结束后随访0.5～3年,观察患手外观及功能恢复情况.结果采用以手术治疗为主,术后配合弹力套加压疗法、外用硅凝胶制剂、瘢痕内药物注射治疗、蜡疗药物导入及功能训练等综合治疗措施,因瘢痕挛缩制约关节功能得到完全或大部分恢复,外观满意.结论手术配合术后物理康复综合治疗,是手部瘢痕治疗的较好方法,值得推广应用.
목적 탐토수부소상후반흔증생적치료방법.방법 대2007～2011년수치적수부소상후반흔증생환자46례78지수,채용반흔절제피편이식、련축송해、극씨침고정38지수,반흔절제국부피판전이18지수,반흔절제식피18지수,반흔절제복부원위확장피판전이4지수,술구반년내균급여탄력투가압요법、외용규응효제제급공능훈련치료,52지수부절구급여사료약물도입치료,26지수부절구유반흔증생,급여반흔내약물주사치료,치료결속후수방0.5～3년,관찰환수외관급공능회복정황.결과 채용이수술치료위주,술후배합탄력투가압요법、외용규응효제제、반흔내약물주사치료、사료약물도입급공능훈련등종합치료조시,인반흔련축제약관절공능득도완전혹대부분회복,외관만의.결론 수술배합술후물리강복종합치료,시수부반흔치료적교호방법,치득추엄응용.
Objective To investigate the value of combined therapy for hand post-burn scars.Methods We retrospectively analyzed 78 hands post-burn scars in 46 cases from 2007 to 2011.A mong them,scar contracture releasing,scar excision,free skin grafting and fixation with Kirschner's pins were performed in 38 hands,scar excision and regional flat transfer were performed in 18 hands,scar excision and skin grafting were performed in 18 hands,abdominal expanded flap transplantation and scar excision were performed in 4 hands.All patients received elastic sleeve pressure therapy,sili cone gel for external application and function training.Within six months after the operation,52 hands received drug delivery by wax therapy,16 hands incision with scar proliferation received drug injection into scar.We followed up all patients from half a year to three years after the treatment to observe the recovery of the appearance and function of the hands.Results We mainly chose surgery,elastic sleeve pressure therapy,silicone gel for external application,drug injection into scar,wax therapy,function training and so on treating the hand post-burn scars and found that the joins deformities caused by scar contracture were largely or totally corrected.The function and appearance were satisfying.Conclusions It is a good method to treat hand scars by surgery and post-surgery combined physical rehabilitation therapy,which deserves to popularization.