A new wound dressing without regular change in surgical treatment for congenital hand or foot deformities
10.3760/cma.j.cn114453-20210704-00284
- VernacularTitle:敷料包扎塑形法在儿童手足畸形整复术后的应用
- Author:
Jun XIAO
1
;
Xiaofei TIAN
;
Lin QIU
;
Yuexian FU
;
Guang YANG
Author Information
1. 重庆医科大学附属儿童医院烧伤整形科 国家儿童健康与疾病临床医学研究中心 儿童发育疾病研究教育部重点实验室 儿科学重庆市重点实验室 400014
- Keywords:
Hand deformities;
Foot deformities;
Wound healing;
Child;
Dressing change;
Joint immobilization
- From:
Chinese Journal of Plastic Surgery
2021;37(12):1350-1355
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce a new wound dressing method without regular dressing change after surgical treatment of hand or foot deformities for children, discuss the key points of application and advantages.Methods:The data of patients with hand and foot deformities who received surgical treatment in Children’s Hospital of Chongqing Medical University from January to December 2019 were retrospectively summarized. After the operation, mupirocin ointment was applied outside the incision, and the layered dressing was used with antiadhesion dressing, sterile gauze and bandage, and adhesive tape. The joint was fixed to the position required by the thickness of the dressing accumulation and the direction of bandage winding. If necessary, a small splint was added to the outer layer, and an observation port was reserved at the top of the finger(toe). Blood supply of fingers(toes) was observed after the operation, and the observation port was closed without abnormal condition 48 h later. If there was no exudation, odor or liquid contamination, the dressing should be changed for the first 2-4 weeks after surgery. The wound healing was observed and recorded during the outpatient visit.Results:A total of 436 patients were enrolled, including 256 males and 180 females. The operative age ranged from 5 months to 6 years old, with an average of 2.6 years. There were 166 cases of syndactyly, 213 cases of polydactyly, 22 cases of hand and foot scar contracture, and 35 cases of other hand and foot deformities. All the cases were aseptic operations on distal wrist and ankle joints. The first time to remove the dressing was 6-33 days after surgery, with an average of 21.3 days. Grade A healing was found in 431 cases (98.9%), grade B healing in 1 case (0.2%), and grade C healing in 4 cases (0.9%). All the incisions were healed by dressing change.Conclusions:With strict aseptic manipulation, it is safe and reliable for children with hand or foot deformities to apply this dressing method without regular change following surgery. The method can satisfy the need for bone and soft tissue healing and substitute for plaster immobilization in preschool patients.
