Analysis of the factors influencing reoperation for severe finger scar contracture in children-clinical data analysis of 61 children.

OBJECTIVE

To explore the factors influencing unplanned reoperation after surgery for severe finger scar contracture in children.

METHODS

The clinical data of children who underwent skin grafting for severe finger scar contracture at the burn and plastic surgery department of Anhui children's hospital from May 2015 to June 2019 were collected, including: etiology, age at surgery, defect area, presence of wound infection, and involvement of multiple joints. We divided the patients into the non-reoperation group (Group A) and the reoperation group (Group B).

RESULTS

A total of 61 children were collected, including 42 boys and 19 girls, with a total of 93 fingers. Among them, 43 children had no repeat surgery, and 18 children had repeat surgery. The finger defect area in Group A was 1.31 ± 0.37 cm2, while in Group B, it was 2.24 ± 0.60 cm2. The time from wound healing in Group A was 8.43 ± 3.11 months, while in Group B, it was 13.67 ± 2.74 months. The number of joints crossed by the scar in Group A was 1.09 ± 0.29, and in Group B, it was 1.57 ± 0.68. There were significant differences between the two groups (p < 0.05). In multivariate logistic regression, the results showed that defect area (OR = 17.64, 95% CI: 2.36-131.81, P = 0.005) and time since the first surgery (OR = 1.39, 95% CI: 1.03-1.91, P = 0.03) independently predicted the need for repeat surgery.

CONCLUSION

The area of skin defect and the time from wound healing in finger scar contractures are independent factors influencing the need for reoperation.