摘要
目的：观察分期分段结扎腹部皮瓣法在修复手部热压伤创面中的应用效果。方法对解放军180医院1997年1月-2013年4月收治的手部热压伤118例应用腹部随意型带蒂皮瓣修复创面,采用术中修薄皮瓣、皮瓣上预置数条丝线、术后分期分段结扎皮瓣等方法,在皮瓣无血循环障碍后断蒂,同时行并指分离术。结果本组行单纯结扎蒂部的68例中65例平均断蒂时间10 d,断蒂及并指分离同时进行的50例中49例平均断蒂时间为16 d,4例延至术后3周断蒂或分指,断蒂及分指后皮瓣无一例坏死,供瓣区一期愈合率达96.6%。105例获得随访,随访时间1~6年,皮瓣外形满意,皮肤感觉大部分恢复,89例手功能恢复好,腹部供区外观良好。结论本方法简单易掌握,成功率高,可减少手术次数,缩短病程,患肢外观功能恢复满意。
Objective To study the application effect of staging and segmenting surgical flaps ligation in repair of hand hot crush injury. Methods A total of 118 patients with hand hot crush injury in 180 Hospital of PLA between January 1997 and April 2013 underwent hang repair with abdominal pedicle skin flaps. During the operation, the skin flaps were thinned with several silk threads. After the operation, staging and segmenting skin flap ligation was performed. When there was no dysemia in the skin flaps, the pedicles were separated by dactylolysis. Results Among the 118 pa-tients, 65 patients in 68 patients underwent simple pedicles ligation with a mean cutting time of 10 d. Both pedicle liga-tion and dactylolysis were performed at the same time in 49 patients in 50 patients with a mean cutting time of 16 d. Pedi-cle ligation or dactylolysis was performed in 4 patients postoperative 3 weeks, and there was no skin flap necrosis after op-erations, and the primary healing rate of donor petaloid area reached 96. 6%. With follow-up for 1-6 years in 105 pa-tients, shapes of skin flaps were satisfactory, and most skin sensation were recovered;89 patients had better hand func-tional rehabilitation with good shapes of donor abdominal petaloid area. Conclusion This method is simple with a high success rate, and it can reduce surgical times and shorten the course of disease with satisfactory hand shape and function.
出处
《解放军医药杂志》
CAS
2014年第8期57-59,共3页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
南京军区重点课题基金(11Z025)
关键词
热压伤
手
外科皮瓣
分段结扎
Hot crush injury
Hand
Surgical flap
Segmenting ligation
