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METHODSThis technique has been used in 19 children with congenital syndactyly. At the dorsum, a flap with V-shaped tip and two wing-shaped pedicle were designed and was just sewed up with an anchor-shaped incision at the palm. The web was primarily reconstructed without skin graft at base of fingers. Distal end of fingers were separated by using serrated flap and were closed after removal of fatty tissue. At some cases with tight skin connection. The defect area at lateral and distal end of fingers was closed by small pieces of skin graft.

RESULTSAll the webs were reconstructed primarily without skin graft at the base of fingers. 7 cases with tight skin connection had small pieces of skin graft at lateral and distal end of fingers. Primary healing was achieved in all cases. After 1 to 6 months of follow-up, both the appearance and function were satisfactory without conspicuous scar. The reconstructed finger webs were in normal depth and width.

CONCLUSIONSPrimary web space can be achieved by dorsal two wing-shaped flap without skin graft at base of fingers. It is one of the best choices for treatment of congenital syndactyly.

Adipose Tissue ; surgery ; Child ; Cicatrix ; Dermatologic Surgical Procedures ; methods ; Fingers ; surgery ; Humans ; Skin Transplantation ; Surgical Flaps ; transplantation ; Syndactyly ; surgery ; Wound Healing

9.New biological dermis cover Pelnac? in wound healing of children with severe trauma

Liang TIAN ; Lin QIU ; Yuexian FU ; Xiaofei TIAN ; Yan LIU ; Jun XIAO

Chinese Journal of Tissue Engineering Research 2014;(16):2601-2606

BACKGROUND:In recent years, tissue engineering has made great progress, and skin tissue engineering is especialy noteworthy. Artificial dermis (PELNAC) is relatively used widely, but there is a lack of relevant reports on wound repair in children. OBJECTIVE:To investigate the clinical efficacy of Pelnac? METHODS:In a retrospective study, 22 patients with the wound of severe trauma were treated with Pelnac as skin graft dressings on treatment of the wounds of severe trauma in children. ? graft, negative-pressure wound therapy and split-thickness skin graft as experimental group (Pelnac? group), and another 19 patients treated with granulation formation dressing and split-thickness skin graft as control group. We colected data including the graft livability, the required re-operative times and the epithelization time after the skin graft. During the folow-up, the skin color and texture of survival skin, subcutaneous fulness, scar hyperplasia and the joint function were also evaluated. RESULTS AND CONCLUSION: In the Pelnac ? group, the graft livability was up to 90% within 10-14 days after grafting. The secondary split-thickness skin graft was required in two cases in the Pelnac? group and in eight cases in the control group. There was a significant difference in the graft livability (P < 0.05). The average epithelization time after the skin graft was (13.86±3.09) days in the Pelnac? group, which was significant shorter than the control group, (19.10±4.62) days, after the first time operation (P< 0.05). During the 10 months folow-up, the survival skin color and skin elasticity in the Pelnac? group was significantly better than that in the control group (P< 0.05). Better subcutaneous fulness and milder scar hyperplasy in the injured sites were obtained in the Pelnac? group compared with the control gorup. Five cases had certain joint function limitation in the Pelnac? group, compared to 10 cases in the control group, with a significant difference (P < 0.05). Artificial dermis Pelnac? has a stronger anti-infectious ability and higher graft livability. Pelnac? graft combined with negative-pressure wound therapy, granulation culture and split-thickness skin graft can shorten the epithelization time, improve wound healing and aleviate harm to the joint function after the skin graft.