摘要
目的介绍上肢大面积皮肤撕脱延期回植的手术方法和临床效果。方法对7例上肢皮肤撕脱面积在25cm×20cm～74cm×32cm的患者，将撕脱皮肤修剪成全厚层或带真皮下血管网的皮片，用抗生索生理盐水纱布包裹，放置于0—4℃的普通冰箱保存；对患肢创面彻底清创、止血、包扎，12—36h后视患者全身和局部情况改善，进行回植。结果4例回植皮片全部成活，3例除部分严重挫伤皮肤呈点状或小片状坏死外，其余皮片全部成活。术后经6～38个月的随访，患肢皮片成活后外观好，挛缩程度轻，肤色正常或接近正常，感觉恢复至S2-S4。结论皮肤冷藏后延期回植治疗上肢大面积皮肤撕脱伤有利于危重患肢的抢救，并能提高回植皮肤的成活率，远期疗效良好。
Objective To introduce the operative method and clinical effect of large area of upper extremity skin avulsion treated by delayed replantation. Methods Seven cases of massive upper extremity skin avulsion were reported. The area of skin avulsion measured 25 cm ×20 cm to 74 cm × 32 cm. The avulsed skin flap was made into full thickness skin graft or subdermal vascular network skin, and then wrapped in antibiotic saline soaked gauze and preserved in refrigerator, between at 0℃ to 4℃ temperature. The injured limb underwent thorough debridement, hemostasis and dressing. 12 to 36 hours later the avulsed skin flap was replanted if the patient＇ s systemic and local conditions improved. Results Complete survival of replanted skin was seen in 4 cases. The majority of the skin replant survived in the other 3 cases except sporadic or patchy necrosis in the area of skin with contusion injury. After 6 to 38 months follow-up, the appearance of the survival skin graft was excellent. There was mild contracture. The eolour of the skin was normal or nearly normal. Sensation reached S2 to S4. Conclusion Delayed replantation of cold preserved skin graft is an effective method for treating massive skin avulsions. It is beneficial for rescuing patients in critical conditions and can also improve the survival rate of replanted skin. The long-term outcome is excellent.
出处
《中华手外科杂志》
CSCD
北大核心
2008年第6期360-362,共3页
Chinese Journal of Hand Surgery
关键词
上肢
创伤和损伤
冷藏
延期回植
Upper extremity
Wounds and injuries
Cold- storage
Delayed replanation
