目的 探讨皮下组织蒂菱形皮瓣成形术治疗烧伤后瘢痕挛缩的效果.方法 选取2019年10月至2022年10月期间莆田市第一医院烧伤整形科收治的烧伤后瘢痕挛缩患者共100例,按治疗方式不同分成研究组(50例)与对照组(50例),对照组采用游离皮片移植术,研究组采用皮下组织蒂菱形皮瓣成形术,统计两组术后1年皮瓣成活率、瘢痕挛缩复发率,比较两组生活质量[生活质量综合评定问卷(Generic Quality of Life Inventory-74,GQOLI-74)]、并发症.结果 术后1年,研究组(100.00%)皮瓣成活率与对照组(92.00%)比较差异有统计学意义(P<0.05),研究组(4.00%)瘢痕挛缩复发率较对照组(18.00%)更低(P<0.05);两组术后1年GQOLI-74评分升高(P<0.05),研究组较对照组更高(P<0.05);研究组(4.00%)并发症发生率较对照组(24.00%)更低(P<0.05).结论 皮下组织蒂菱形皮瓣成形术治疗烧伤后瘢痕挛缩皮瓣成活率较高,可降低瘢痕挛缩复发率、生活质量提高,降低并发症发生风险.
Effect of Subcutaneous Tissue Pedicle Diamond Shaped Skin Flap Reconstruction for the Treatment of Scar Contracture Patients After Burns
Objective To explore the effect of subcutaneous tissue pedicle diamond shaped skin flap reconstruction in the treatment of scar contracture after bums.Methods A total of 100 patients with post-burn scar contracture from October 2019 to October 2022 who were admitted in Putian First Hospital were divided into the study group(n=50,subcutaneous tissue pedicle diamond flap reconstruction surgery)and the control group(n=50,free skin grafting surgery).The survival rate of the skin flap and the recurrence rate of scar contracture at 1 year after surgery were statistically analyzed,and the quality of life(Generic Quality of Life Inventory-74,GQOLI-74)and complications were compared in both groups.Results One year after surgery,in the survival rate of the skin flap,there was statistically significant difference in the study group(100.00%)and the control group(92.00%)(P<0.05).In the recurrence rate of scar contracture,in comparision of the control group(18.00%),the study group(4.00%)was lower(P<0.05).One year after surgery,the GQOLI-74 scores in both groups were increased(P<0.05),and in comparision of the control group,the study group was higher(P<0.05).In the incidence of complications,in comparision of the control group(24.00%),the study group(4.00%)was lower(P<0.05).Conclusion The subcutaneous tissue pedicled diamond shaped skin flap has a higher survival rate in the treatment of scar contracture after burns,which can reduce the recurrence rate of scar contracture,improve quality of life,and reduce the occurrence of complications..