手部开放性损伤皮肤缺损的早期处理  

Early treatment of hand open injury with skin defect

作　　者：李宝山[1] 章雪松[1] 邹豪杰[1] 刘双利[1] 刘俊辰[1] 

机构地区：[1]中国人民解放军第285医院手外科,河北邯郸056001

出　　处：《实用手外科杂志》2006年第3期144-146,共3页Journal of Practical Hand Surgery

摘　　要：目的报道直接缝合、游离植皮及多种皮瓣在手部开放性损伤皮肤缺损中的治疗效果。方法1992年以来应用直接缝合、游离植皮、带蒂皮瓣移植、筋膜蒂皮瓣转移、推进皮瓣、指动脉为蒂岛状皮瓣移植及吻合血管皮瓣移植等方法对1298例手部开放性损伤的皮肤缺损进行修复。结果本组1298例,随访976例,除126例吻合血管移植皮瓣,有9例出现水泡,远端部分皮缘坏死,经换药愈合外,其它各种方法均能一期愈合,并恢复良好的功能及皮瓣的保护性感觉。结论根据开放性手部损伤皮肤缺损的具体情况,损伤程度类型,采取不同的处理方法,均能获良好的功能。Objective To report the clinical result of hand skin defect repaired by direct suturation、free skin graft transplantation and flaps in open injury.Methods Since 1992,1298 cases have been treated.Skin-defect in hand injury were repaired with free skin graft transplantation、pedicled skin flap、directly suture、advanced skin flap、reverse digital artery island flap and vessel-anastomosis flap etal.Results 976 cases were followed up.All cases were primarily healed with good function and protective sensation.There were 2 flaps necrosis in 31 reverse digital artery island flaps,which healed after repaired by subaxillary flaps.3 flaps necrosis in 103 fascial flaps had been healed after repaired by advanced skin flaps.While 9 cases had distal partial necrosis and healed after dressing change.Conclusion According to different injury type,good function can be achieved in treatment of hand skin defect by different treatment methods.

关 键 词：手部损伤 皮肤缺损 皮瓣 

分 类 号：R658.2[医药卫生—外科学]