Objective
To investigate the effectiveness of repairing severe cicatricial contracture deformity in the web-space by kite-like incision combined with full-thickness skin grafting.
Methods
Between June 2008 and September 2011, 31 patients (87 web-spaces) with severe cicatricial contracture deformities in the web-spaces were treated. There were 24 males and 7 females, aged 5-43 years (median, 22 years). The causes of injuries were flame burn (26 cases), scald (3 cases), electric arc burn (1 case), and chemical burn (1 case). The degree of burn was deep second degree (14 cases) and third degree (17 cases). The interval time from injury to operation was 10 months to 17 years (median, 2.2 years). The kite-like incision was marked on the scar in the web-space. The rhombic scar between the adjacent metacarpophalangeal joints was excised, and cicatricial contracture was released completely. The secondary wound in the web-space was repaired with full-thickness autogeneic skin grafting. The secondary wound at donor site was directly sutured.
Results
All full-thickness skin grafts survived well. The incisions at donor sites healed primarily. Of 31 patients, 29 (82 web-spaces) were followed up 6-18 months (mean, 13 months). The sizes and depths of reconstructed web-spaces were similar to those of normal ones. No secondary cicatricial contracture was observed, and the function of fingers recovered well.
Conclusion
The short-term effectiveness is satisfactory by kite-like incision combined with full-thickness skin grafting for repairing severe cicatricial contracture deformities in the web-space, while the long-term effectiveness needs further observation.
