Application of skin and soft tissue expansion in the repair of hypertrophic scar in children's neck and chest
Objective To investigate the clinical effect of skin and soft tissue expansion to repair hyperplastic scar in children's neck and chest.Methods A retrospective analysis was performed on 6 cases of children with cervicothoracic hypertrophic scar admitted to Department of Skin Wound Repair Center,Tongren Hospital of Wuhan University&Wuhan Third Hospital from January 2015 to De-cember 2021.The skin and soft tissue dilator was implanted into the normal skin on the scar side of the neck and chest in the first stage.The dilator was dilated by water injection for about 3 months after the operation,and remained for 2 weeks after the dilation was sufficient.In the second stage,the expanded skin flap was repaired.The dilator was removed,the hyperplastic scar was removed,and the expanded skin flap was pushed toward the chest to repair the wound.The survival of the flap and the complications of each stage of operation were observed.Regular follow-up was conducted by telephone interview and outpatient review to observe scar hyperplasia and postoperative sat-isfaction of the children and their families.Results There was no infection occurred,no dilator was exposed,the skin flap survived well,and no incision split occurred in 6 patients after dilator implantation.All the children were followed up for 1 to 5 years after the extended flap repair,and the scar hyperplasia of the neck and chest of the children was not obvious,some of the children left flat scars,and the symptoms of pain and itching were significantly improved,and the children and their families were highly satisfied.Conclusion It is safe,reliable and effective to use skin and soft tissue dilation to repair hyperplastic scar in children's neck and chest.The normal skin on the side of scar is the preferred location for the design of arbitrarily expanded flaps.
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