摘要
目的 探讨手部脱套伤的分型和术式选择. 方法 总结我科2005年1月-2014年12月共68例手部脱套伤病例,首先按脱套组织损伤的程度分型：Ⅰ型脱套组织血运存在,予以清创缝合术;Ⅱ型脱套组织血运差或者无,但仍可通过手术恢复血运或者修薄回植于创面,后者仅限于手掌、手背脱套伤;Ⅲ型脱套组织无血运或者毁损,无法利用脱套组织、需要切取其他组织修复创面.其次根据脱套部位和范围的不同分A、B、C三个亚型,并对应具体手术方案. 结果 本组病例总体成活率83.8％,随着脱套组织损伤程度和范围的增加伤情加重,组织成活率下降. 结论 综合考虑手部脱套伤的损伤程度、部位和范围对其分型,有利于伤情的判断和术式的选择.
Objective To discuss the classification and treatment of the degloving hand.Methods All 68 degloving hand treated between January, 2005 and December, 2014 in our department were reviewed.The cases were divided into three types according to the extent of the injury.Type Ⅰ the degloving tissue had enough blood supply which was debrided and stitched.Type Ⅱ the degloving tissue had less or no blood supply which was revascularized with replantation or vein anastomosis, some degloving palm or dorsum resurfaced the wound by the degloving skin graft.Type Ⅲ the degloving tissue had no blood supply or severely damaged,the tissue defect should be resurfaced with other tissue reconstruction.Type Ⅱ and Ⅲ were further divided into subtype A, B and C depending on the degloving scope and location, each subtype has its own surgical procedure.Results The total survival rate was 83.8%.The survival rate decreased with the increasing extent of the injury and the increasing degloving scope.Conclusion Classification of the hand degloving injuries depending on the extent of the injury, the degloving scope and location is useful for the assessment of injury and the selection of proper operation procedures.
出处
《中华显微外科杂志》
CSCD
北大核心
2015年第6期557-560,共4页
Chinese Journal of Microsurgery
基金
浙江省医药卫生科学研究基金（2009A146）
关键词
手部脱套伤
再植
外科皮瓣
重建
Degloving hand
Replantation
Surgical flap
Reconstruction
