摘要
目的探讨手部皮肤撕脱伤的急诊手术治疗效果。方法54例手部皮肤撕脱伤患者全部采用急诊手术方法治疗。其中原位缝合12例,将撕脱皮肤修剪成中厚皮片回植8例,中厚皮片游离植皮9例,腹部带蒂真皮下血管网皮瓣18例,指动脉逆行岛状皮瓣6例,筋膜蒂逆行岛状皮瓣1例。结果53例创面成功修复,1例原位缝合术后皮肤约30%坏死,经二期游离植皮修复。54例均获随访,时间6～24个月,皮肤质地柔软,外观满意,感觉、运动功能恢复较好。结论针对手部皮肤撕脱伤不同伤部情况,准确判断皮肤撕脱伤的损伤程度,应用上述方法急诊修复,能最大限度地恢复伤手的外形与功能。
Objective To investigate the curative effect of avulsion injury of skin in hand treated by emergency operation. Methods 54 cases with avulsion injuries of skin in hand were treated by emergency operation. 12 cases were sutured in situ,8 cases were trimmed as intermediate split thickness skin graft,9 cases were repaired by dissociation skin grafting. 18 cases were repaired by abdomen pedicle skin flap of subdermal vascular plexus,6 cases were repaired by retrograde arteria digitalis island flap,and 1 case was repaired by retrograde aponeurosis pedicle island flap. Results 53cases got satisfactory soft tissue coverage. 1case was complicated with 30% flap necrosis and was repaired by dissociation skin grafting two weeks later. 43 cases were followed-up for 624 months. The contours of hands were fine,and the sensation of pain,temperature and tactile recovered well,and the motion of joint achieved functional recovery. Conclusions According to accurate judgment of severity of injury,above-mentioned operation method is selected,and curative effect can be gained.
出处
《临床骨科杂志》
2009年第4期390-392,共3页
Journal of Clinical Orthopaedics
