Scar Management of the Burned Hand.
Scar Management of the Burned Hand.
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DOI：
10.1016/j.hcl.2016.12.009
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发表时间：
2017-05
期刊：
影响因子：
1.1
通讯作者：
Levi B
中科院分区：
文献类型：
--
作者：
Sorkin M;Cholok D;Levi B
完好的手部功能在几乎所有的日常生活活动中都是至关重要的。烧伤可导致增生性瘢痕形成，可导致衰弱的功能缺陷和不良的审美结果。急性烧伤处理的初始算法包括早期清创和植皮以及早期活动，以防止形成肥厚性疤痕和最终的手指挛缩。虽然疤痕成熟早期的非手术方式对于减少增生性疤痕的形成至关重要，但为了恢复手功能，通常需要手术治疗。手术治疗瘢痕的基本要素是张力的释放，这通常可以通过局部组织重排来实现。激光治疗已成为后续疤痕康复的核心支柱，有几种治疗疤痕质地、颜色、瘙痒和厚度的方法。这些可以与局部皮质类固醇治疗和其他新兴模式结合使用，以调节疤痕并实现最佳手功能。这些治疗工具为重建外科医生治疗增生性手部疤痕提供了有效的资源。
Unimpaired hand function is critical in almost all activities of daily living. Burn injury can result in hypertrophic scar formation that can lead to debilitating functional deficits and poor aesthetic outcomes. Initial algorithms of acute burn management involve early debridement and skin grafting and early mobilization to prevent formation of hypertrophic scarring and ultimately digit contractures. While non-operative modalities in the early phase of scar maturation are critical to minimize hypertrophic scar formation, surgical management is often indicated in order to restore hand function. The essential tenant of operative scar management is release of tension, which can often be achieved through local tissue rearrangement. Laser therapy has emerged as a central pillar of subsequent scar rehabilitation with several modalities that address scar texture, color, pruritis and thickness. These can be utilized in conjunction with local corticosteroid treatment and other emerging modalities to modulate the scar and achieve optimal hand function. These treatment tools provide an effective resource for the reconstructive surgeon to treat hypertrophic hand scars.