Objective To explore the clinical effects of artificial dermis combined with autologous split-thickness skin graft in the treatment of severe hand burn scar contracture.Methods From January 2018 to December 2022,17 patients(22 affected hands)with severe hand burn scar contracture were treated at Plastic and Reconstructive Surgery Department of the Sixth Hospital of Ningbo,including 14 males and 3 females,aged 24-81 years old.Artificial dermis combined with autologous split-thickness skin was used for treatment.Scar contracture release,joint reduction and internal fixation,double-layer artificial dermis skin grafting,and continuous negative pressure suction were conducted in the first stage surgery.Split-thickness skin graft was used for wound repair in the second stage surgery.Functional exercise,elastic compression therapy,laser therapy,and topical use of silicone drugs were performed to prevent scar hyperplasia.Measured total active motion(TAM)of finger and activities of daily living(ADL)scores before and 6 months after surgery.Observed the texture and pigmentation of the skin in the graft area.Results After treatment,the TAM of finger improved[(37.05±16.23)° vs.(183.64±15.97)°,t =-30.191,P＜0.001]and ADL score enhanced significantly[(43.24±9.51)vs.(84.41±6.09),t =-15.031,P＜0.001].The patients were followed up for 6-18 months,the skin in the graft area was soft and smooth,with no obvious secondary contractures observed.Five cases occured significant pigmentation in the graft area.Conclusion The combination of artificial dermis and autologous split-thickness skin graft can effectively improve hand dysfunction,enhance self-care ability,and improve quality of life in the treatment of severe hand burn scar contracture.
维普
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