摘要
目的探讨手部套脱伤的分型及对应的治疗方法。方法2000-2004年,对我院44例手部套脱伤患者的资料进行分析,按皮肤撕脱范围分为以下四型：Ⅰ型(单指型)15例,Ⅱ型(多指型)8例,Ⅲ型(多指合并手掌背部皮肤套脱伤)12例,Ⅳ型(全手皮肤套脱伤)9例。Ⅰ～Ⅲ型根据是否合并拇指损伤又分为A、B亚型。分别采用手部岛状皮瓣转移术、腹部插袋术、腹部带蒂皮瓣移植术、游离皮瓣移植术、(足母)甲瓣或第二足趾移植术进行修复和重建。结果除2例皮瓣部分坏死外,其余皮瓣全部存活。按中华医学会手外科学会上肢部分功能评定试用标准评定：优14例,良15例,可10例,差5例。结论手部套脱伤的分型有利于手术方式的选择,及对预后的判断；一期游离复合组织瓣的移植可缩短疗程,促进早日康复。
Objective To discuss the classification and treatment of hand degloving injuries. Methods 44 cases of hand degloving injuries treated between 2000 and 2004 were reviewed. The cases were divided into four typos according to the extent of the injury. There were 15 cases of type Ⅰ which only had single finger involvement, 8 cases of type Ⅱ with multiple finger involvement, 12 cases of type Ⅲ with multiple finger and palm involvement, and 9 cases of type Ⅳ of total hand degloving injury. Type Ⅰ - Ⅲ were further divided into subtype A and B depending on involvement of the thumb. The mini-island flaps in the hand, abdominal pocket flap, groin flap, flee flap, wrap around flap, and second toe transfer were used for coverage and reconstruction. Results Except for partial necrosis of the flaps in 2 cases, all other flaps survived completely. According to the hand function evaluation criteria of the Chinese Hand Surgery Society, 14 cases were graded as excellent, 15 cases as good, 10 cases as fair, and 5 cases as poor. Conclusion Classification of hand degloving injuries is useful for the selection of proper operation procedures and the assessment of prognosis. Free composite tissue transfer can shorten the course of the treatment and facilitate early rehabilitation.
出处
《中华手外科杂志》
CSCD
北大核心
2006年第4期221-223,共3页
Chinese Journal of Hand Surgery
关键词
手损伤
分类法
外科皮瓣
套脱伤
Hand injuries
Classification
Surgical flaps
Degloving injuries
