Scar contracture deformity repair

Malformation caused by scar is a common surgical disease, mostly caused by burns, other trauma and infection, especially scar contracture after burn is the most common. In addition to causing changes in shape, it is more important to cause dysfunction and affect labor; too long can cause joint stiffness, nerve and blood vessel shortening, etc. Although surgical treatment, functional recovery is not satisfactory, so patients should be relieved as soon as possible. pain. Scars can be divided into stability and instability. In the unstable scar stage, there is a clear inflammatory reaction, and the scar appears to be congested. Unstable scars can develop into hypertrophic scars, which can also be converted into flat scars, which usually become stable scars after 1 to 2 years. In the unstable phase, it is not suitable for surgery, because there are many intraoperative hemorrhages, high surgical failure rate, and poor effect. It is necessary to be operated after it is converted into stable scar. The best treatment time: general surgery is recommended to be treated after the initial diagnosis of the disease, special surgery should be prescribed. Treatment of diseases: burns in children Indication 1. The contracture scar that affects the function. After the transformation is stable, it is necessary to treat it early. 2. The deformity of the eyelid valgus should be repaired early to prevent corneal ulcer caused by long-term exposure of the cornea. 3. Painful scars affect the function, can be completely removed and repaired. 4. For scars that are susceptible to friction and ulceration for a long time, it should be removed and repaired early. 5. Scars that are exposed to the affected area should also be removed and repaired. Contraindications No relevant information. Preoperative preparation 1. Comprehensively inquire about the medical history and perform a systemic examination to understand the patient's health status. If there are other acute diseases, they must be cured before surgery. If there is a chronic disease, it is necessary to comprehensively measure the stakes and make a careful decision. 2. Correctly predict the size of the wound after the scar is removed to prepare a sufficient skin or flap. For large scars, it can be planned to be divided and repaired according to the scar range. 3. Determine the depth of the scar to facilitate the choice of repair method. For example, the scar caused by second degree burn is shallow. After the resection, the skin can be used to repair the wound. The scar caused by the third degree burn is deep. After resection, the tendon, blood vessels, nerves, joints or bones may be exposed. It must be repaired with a flap. . 4. Check the bleeding time and clotting time to understand the patient's coagulation function. If there is any abnormality, it should be corrected before surgery. 5. Long-term scar contracture in the joint area can cause stiffness or shortening of blood vessels and nerves. Before the operation, the Chinese medicine can be smoked and soaked, soaked, or treated with physiotherapy or traction to correct part of the deformity and reduce the complexity of the operation. 6. The dirt in the surgical area and the donor area (especially in the scar sulcus) should be removed. The scar on the limb should be soaked with 1:2000 Xinjieer 2 to 3 days before surgery to avoid postoperative infection. Surgical procedure [Clinical types of scars and choice of surgical methods] The clinical manifestations of scars are diverse. For treatment needs, scars can be classified into two types: light contracture and heavy contracture. 1. Light scar contracture: the depth of the scar is shallow, and does not invade tissues such as deep tendons, nerves, bones and joint capsules. Light scars can be divided into three types: strips, braids and flaky scars. (1) Corrugated and sacral scar contracture: For light cord-like scars (such as mild valgus valgus) can be repaired by vy forming technique. When the scar is soft, it can be repaired by z-shaped or continuous z-shaped. When separating the triangular flaps on both sides, it should be noted that the thickness of the flap should be uniform, otherwise the triangle flap necrosis can be caused. (2) flaky scar: after resection, it can be directly repaired with medium or full thickness skin. 2. Heavy scar contracture: scar tissue affects deep tendons, blood vessels (aorta), nerves, joint capsules and bones. Severe burns can even cause partial or complete defects in the fingers (toes) and limbs. This type of deformity can occur, such as the claw-shaped hand is the most common type of typical deformity. When repairing, it is necessary to use a flat flap or a tubular flap (skin tube) for repair according to different parts and ranges. complication 1. Acne: After bed rest, prone to acne. 2. Infection: Wound bleeding, improper exudate care is easy to cause.