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Treatment of hand scar contracture deformity with skin transplantation
From 1985 to 1994, we treated 102 cases of hand scar contracture deformity by skin grafting, including 66 males and 36 females. Age 3 ~ 20 years old. All cases were contracture deformity after hand burn, including 60 cases of hand; There were 76 cases of finger and palm flexion contracture and 26 cases of dorsal flexion contracture. The course of disease is 4 months to 8 years. The surgical method is to completely release the scar and remove it to normal tissue, and try to correct the deformity at one time without affecting the blood supply and feeling of fingers. Those located between webbed fingers should be treated with "Y" incision and released at the same time. Correct the edge of the incision to make it conform to the physiological incision of the hand. When the assistant supports the correction position, the full-thickness skin graft taken from the abdomen should be 0.7 ~ 1.0 larger than the periphery of the hand wound.

Cm, properly trimmed skin graft, and soaked in gentamicin saline. Expose the hand wound, stop the bleeding completely by clamp method, suture the skin graft and the wound without tension, and bandage it with pressure. Antibiotics were used to prevent infection after operation, and stitches were removed two weeks later, that is, finger function exercise and local skin massage were carried out. All the patients in this group survived in one stage, and the deformity was corrected to the preoperative design. Moreover, the skin in the skin graft area has good elasticity, strong wear resistance and shallow pigmentation. Follow-up for 3 ~ 5 years showed that hand function recovered well and contracture did not recur.

The characteristics of this method are as follows: ① The corrected finger is not fixed with Kirschner wire to prevent the finger joint from being stiff; ② The wound is not ligated to stop bleeding, which reduces the retention of foreign bodies and increases the contact surface of skin grafting; ③ Tension-free suture skin grafting is beneficial to the growth of new capillaries and accelerates the recovery of blood supply for skin grafting; ④ Maintain the thickness of skin graft to make it wear-resistant and elastic, accelerate the recovery of hand function and prevent complications.