摘要
目的:重度热压伤者深层组织暴露,断层或全厚皮片移植不能覆盖神经、肌腱、皮质骨,临床常采用早期皮瓣移植修复,本组观察22例手部重度热压伤患者的治疗效果,进行了重复性的经验验证。方法:选择2001-01/2006-06解放军第八五医院烧伤整形外科收治的皮瓣移植修复治疗手部重度热压伤患者22例,对治疗方案均知情同意。其中选择手部局部皮瓣4例,上臂管型皮瓣3例,腹部随意带蒂皮瓣10例,腹部轴型皮瓣5例。术后进行康复治疗,定期随访,根据伤情和手功能恢复情况评估疗效。结果:①术后各种皮瓣全部成活,随访6￣12个月,皮瓣颜色质地均佳,手外形和功能恢复满意。②22例患者治疗效果优、良、差者分别为10,7,5例。③伤后急诊手术及1周内手术者17例,愈合优良率为82%;2周内手术者5例,愈合优良率为60%。结论:根据不同的热压伤创面选用相应的皮瓣进行早期移植修复,术后同时进行康复治疗,可最大限度地恢复手的外形和功能。
AIM： The exposure of deep tissue in patients with severe hot crush injury may result in the failure of covering nerve, tendon and cortex bone by fault or full-thick skin graft, and skin flap transplantation is frequently applied in clinical repairing. This study is designed to investigate the effect of skin flaps repairing severe hot crush injury of hand in 22 patients and verify the reproducibility.
METHODS： From January 2001 to June 2006, 22 patients with severe hot crush injury of hand ware repaired by various skin flaps transfer in Department of Burns and Plastic Surgery, the 85 Hospital of Chinese PLA. Informed consents ware obtained from all the patients. Surgical flap included hand local skin flap （4 cases）, arm tubed skin flap （3 cases）, abdominal direct carring skin flap （10 cases） and abdominal axial pattern skin flap （5 cases）. Postoperative patients ware treated by function rehabilitation in early stage, and the curative effect was evaluated based on the traumatic condition and hand function condition.
RESULTS： ①AII the flaps were survived with satisfactory hand function recovery. Patients were followed up for 6-12 months. The color, texture and appearance of the flaps were good.②Clinical effect was graded as excellent in 10 cases, good in 7 cases and poor in 5 cases.③The good and excellent rate in 17 cases, for whom the interval from initial injury to surgery was shorter than 7 days, reached 82% and was better than that in 5 cases （60%）, for whom the interval was longer than 7 days.
CONCLUSION： Different skin flaps are adopted to repair severe hot crush injury of hand according to different skin defects of the hand, meanwhile early function rehabilitation is combined to achieve good recovery of function and appearance of the hand at the greatest extent.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第47期9578-9580,共3页
Journal of Clinical Rehabilitative Tissue Engineering Research
