title: [Repair of scar contracture in whole dorsum of hand by expanded full-thickness skin graft].
abstract: OBJECTIVE
  To investigate the feasibility of repairing secondary wounds after scar excision in patients with scar contracture in whole dorsum of the hands by expanded full-thickness skin grafts.
  
  
  METHODS
  Between February 2008 and February 2011, 15 patients (19 hands) with scar contracture in whole dorsum of the hands were treated. There were 12 males (14 hands) and 3 females (5 hands), aged 18-43 years (mean, 28.6 years). The disease duration was 6-22 months (mean, 13.2 months). All cases complicated by different degrees of metacarpophalangeal joint extension deformity and interphalangeal joint flexion deformity. In one-stage operation, soft tissue expanders were implanted at donor sites, and the time of water injection was 4-5 months; in two-stage operation, scar was excised and secondary wound (14 cm x 9 cm-25 cm x 16 cm in size) was repaired with the expanded full-thickness skin grafts.
  
  
  RESULTS
  After one-stage operation, the others had good blood supply except 1 case of skin necrosis in the center of expanded skin flap. After two-stage operation, the full-thickness skin grafts survived well in 18 hands; subepidermal effusion occurred in 1 hand, which was cured after changing dressing. The incisions at donor sites healed well in all cases. All patients were followed up 6-18 months (mean, 13.7 months). The grafts were excellent in color, texture, and elasticity, and no hypertrophic scar was observed at the edge and joint of the grafts. The hand function recovered well; the flexion and extension of wrist joint, metacarpophalangeal joint and interphalangeal joint were normal.
  
  
  CONCLUSIONS
  The expanded full-thickness skin graft is a suitable solution to repair effectively scar contracture in whole dorsum of the hands because it has good results in the cosmetic appearance and function recovery of the hands.
authors.affiliation: Department of Burns and Plastic Surgery, First Affiliated Hospital, General Hospital of Chinese PLA, Beijing, 100048, P.R.China. lianglm304@yahoo.com.cn
authors.forename: Liming
authors.initials: L
authors.lastname: Liang
authors.forename: Jiake
authors.initials: J
authors.lastname: Chai
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Jia
authors.forename: Sa
authors.initials: S
authors.lastname: Jing
authors.forename: Yirong
authors.initials: Y
authors.lastname: Wang
authors.forename: Suyu
authors.initials: S
authors.lastname: Meng
authors.forename: Tao
authors.initials: T
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000328:Adult; D002056:Burns / Q000150:complications; D002921:Cicatrix / Q000601:surgery*; D003286:Contracture / Q000601:surgery*; D005260:Female; D005383:Finger Injuries / Q000601:surgery; D006230:Hand Injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D016038:Skin Transplantation; D013524:Surgical Flaps / Q000098:blood supply; D015626:Tissue Expansion / Q000379:methods; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult