Clinical efficacy of combined therapy with composite skin grafting, photoelectric technology, and functional rehabilitation in repairing pediatric scar contracture deformities
10.3760/cma.j.cn431274-20250317-00356
- VernacularTitle:复合皮移植术联合激光技术及功能康复的综合疗法修复小儿瘢痕挛缩畸形的临床效果
- Author:
Fei HAN
1
;
Peng JI
1
;
Ke TAO
1
Author Information
1. 空军军医大学第一附属医院烧伤与皮肤外科，西安 710032
- Publication Type:Journal Article
- Keywords:
Cicatricial contracture;
Composite flap;
Laser technology;
Functional rehabilitation;
Child
- From:
Journal of Chinese Physician
2025;27(10):1473-1477
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the efficacy of combined therapy with composite skin grafting, photoelectric technology, and functional rehabilitation in repairing pediatric scar contracture deformities.Methods:A total of 15 children with scar contractures (9 males and 6 females, aged 1-7 years) admitted to the First Affiliated Hospital of the Air Force Medical University from January to June 2024 were included. The scars were distributed on the extremities (12 cases) and trunk (3 cases), all formed 1 month to 1 year after burns/scalds, with areas ranging from 2 cm×7 cm to 6 cm×20 cm. The surgery was divided into two stages: Stage Ⅰ involved complete release and resection of scar tissue (wound area: 3 cm×8 cm to 9 cm×22 cm); Stage Ⅱ involved composite skin grafting combined with autologous thick split-thickness scalp skin coverage. Skin graft survival and complications were evaluated 10 days postoperatively. Anti-scar medications, pressure therapy, laser therapy, and functional training were initiated 2 weeks postoperatively, with dynamic efficacy evaluation throughout the process. During the 6-12 month follow-up, scar characteristics of the repaired area [Vancouver Scar Scale (VSS)] and joint range of motion were assessed.Results:All skin grafts survived in the children. Subcutaneous hematomas occurred in 2 cases (1 cm×2 cm and 0.5 cm×1 cm), which healed after aspiration and compression. The skin of the repaired area was soft with color close to normal skin; VSS scores were significantly lower than those before scar treatment ( P<0.05); joint range of motion was significantly improved before treatment ( P<0.05). The edges of the skin grafts showed linear scars without functional impact. Thirteen families were very satisfied with the efficacy, and 2 families were satisfied. No scar recurrence or other adverse reactions occurred after scar treatment in all cases. Conclusions:The combined therapy of composite skin grafting, photoelectric technology, and functional rehabilitation can effectively repair pediatric scar contracture deformities, with advantages such as good recovery of appearance and function, and minimal damage to the donor site.
