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2013, Number 1

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Cir Plast 2013; 23 (1)

Reconstruction of the burned hand using acellular dermal matrix

Cuenca-Pardo J, Álvarez-Díaz CJ

Language: Spanish
References: 32
Page: 43-54
PDF size: 445.40 Kb.


ABSTRACT

We studied 26 hands in 13 patients, with hypertrophic scars shrunken on the back of their hands, with claw deformity in varying degrees, closure of the interdigital spaces, thumb with forced adduction and dorsal retraction and functional disorders characterized by the lack of opposability, finger abduction and lack of finger flexion and prehension. During the first surgery scars and retraction bands were resected and exposed structures were covered with the matrix. Fourteen days later the silicone matrix cover was removed and skin grafts of 10 thousandths inch were applied. There were two patients whose outer shell came off with partial loss of the matrix and subsequent retraction of the grafts. The results were evaluated six months, one and two years after reconstruction, discovering in 91.3% of the treated hands a cover similar to normal skin, with flexibility, without adherence to tendons or joints, opening of interdigital spaces, correction of thumb and clawing. Functional improvements were: complete finger abduction, opposition of the thumb, finger flexion and prehensile force recovered. The dermal matrix reconstruction of burned hands turned out to be very useful, with good aesthetic and functional results.


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