Observation on the clinical effect of using full thickness plantar skin grafting after scar excision on the palmar side of children's hands
Objective To observe the clinical efficacy of using full-thickness plantar skin grafting to treat pediatric palmar scar contracture deformity.Methods From January 2021 to December 2022,63 children with palmar scar contracture deformity were treated,including 34 males and 29 females.The age was ranged from 11 months to 7 years and 4 months.After surgical release and excision of contracted scar tissue,full thickness skin grafts were used for coverage.According to the supply of full thickness skin grafts,they were divided into two groups:the medial plantar area(36 cases)and the inguinal area(27 cases).The total active range of motion(TAM)was used to evaluate the recovery of hand function in two groups of patients after surgery.The Vancouver Scar Assessment Scale(VSS)was used to evaluate the appearance,color,vascular distribution,and softness of the skin graft recipient and donor areas in two groups of children.The parental satisfaction with surgical outcomes was assessed.Results All 63 patients were follow-up for 6 to 18 months after surgery,and TAM was used to evaluate the recovery of hand function.There was no statistically significant difference between the two groups(Z=0.128,P＞0.05).The VSS scale was used to evaluate the scar tissue in the graft recipient area and donor area.The color score of the graft recipient area was lower in the medial plantar area group than in the inguinal area group,and the difference was statistically significant(Z=6.589,P＜0.001).The comparison of scar thickness between the recipient and donor areas showed that the scores in the medial plantar area group were lower than those in the inguinal area group,with statistical significance(Z=2.653,P＜0.01;Z=4.942,P＜0.001).There was no statistically significant difference in the scores of other sub items(P＞0.05).The comparison of parental satisfaction with the effectiveness of skin grafting surgery showed that the proportion of those who rated as excellent was higher in the medial plantar area group than in the inguinal area group,and the difference was statistically significant(Z=2.430,P＜0.05).Conclusion The use of full-thickness plantar skin grafting for the treatment of palmar scar contracture in children has shown good functional recovery,especially with significant improvement in appearance,and the clinical effect is definite.
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