Skin Grafts Vs. Local Skin Flaps in Management of Contracted Scar Finger

Volume 4 - Issue 5

Khaled Noureldin, Ahmed Shalaby* and Marwa Badawi

Received:April 22, 2020   Published:May 04, 2020

DOI: 10.32474/SCSOAJ.2020.04.000200

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Abstract

Purpose: In our study, we reviewed the outcome of using skin grafts and different regional flaps of the hand in order to correct flexion contractures of the Proximal Interphalangeal (PIP) joints of fingers. In both techniques, vigorous postoperative exercises were advised for an interval of time between 3-6 months.

Patients and Methods: 16 patients were included in our study. All the scar tissue was excised, and the resultant raw area was covered. In Group A consisting of 8 patients, skin grafts were used. Split thickness grafts were selected in 3 cases and full thickness grafts in 5 cases. While in group B, Z-plasty and Cross finger regional flaps were used in 4 cases per each flap. The cause of the contracture was thermal burn in 8 patients, mechanical trauma in 7 cases, and a case of contracture secondary to dupytrene’s disease. The mean follow-up period was 6 months.

Results: The mean flexion contracture/further flexion in the joints were improved markedly at the last follow-up. More extension was gained by exercising after the operation. Near full ROM was achieved in 15 cases with strong hand grip and cosmetic satisfaction. There were no major complications.

Conclusion: Wise selection between different skin grafts and regional skin flaps is important, in order to achieve best outcome in managing finger contractures and gain satisfactory ROM. Choosing the best reconstruction method depend on the size, extent and depth of the raw area. Exposure of the deep structures is an indication to use skin flaps over grafts. Vigorous extension exercise is mandatory to have the best results.

Keywords: Flexion contracture, finger, surgical release, skin grafts, regional skin flap, Vigorous extension exercise

Abstract| Introduction| Materials and Methods| Results| Discussion| Conclusion| References|