DefinePK

Abstract

A severe and deep thermal injury is usually followed by sequalae of functional limitation. Contractures are more likely to occur regardless of the initial management. The most frequently occurring functional limitation sequalae includes contracture of hands, digits, and webspace. Scar excision along with local soft tissue rearrangement and/or skin grafting is used to manage the post- burn syndactyly as well as the webspace contracture. In case of metacarpophalangeal joints, the burned claw hand is presented as extension contracture and in case of proximal interphalangeal joints, it is presented as flexion contracture. The surgical intervention to ensure the complete management of these contractures include scar tissue surgical excision and resulting soft tissue defect resurfacing along with full thickness skin graft. The study is the comparative analysis of z plasty against the z plasty with skin graft in the tension free surgical treatment of post-burn hand contracture. It includes 53 post burn hand contracture patients treated with z plasty alone and z plasty with skin graft. In both treatment conditions, the design of z plasty was 40–45-degree angle. Flap rotation was without tension and mid split thickness skin graft was used to graft them. Moreover, surgical area is examined for any sort of post-operative wound healing time, infection, scar, and necrosis. Only three cases treated with z plasty alone had some complications. The results showed that treatment with z plasty along with skin graft showed better results compared to treatment of z plasty alone. The study concludes that choice of contracture treatment depends upon degree of contracture and the available surrounding healthy tissue. Moreover, the combined treatment of z plasty with skin graft showed better results compared to z plasty alone in the study