全头皮撕脱伤手术方案选择分析  

Review on management of scalp avulsion inlurv (report of 16 cases)

作　　者：刘宁涛[1] 潘庆刚[1] 李世亭[1] 王戌元[1] 李心远[1] 王飞[1] 

机构地区：[1]同济大学附属同济医院神经外科,上海200065

出　　处：《实用神经疾病杂志》2004年第5期4-5,共2页

基　　金：东莞市科技局基金资助(课题号:B2002-5)

摘　　要：目的 回顾总结全头皮撕脱伤临床资料,探讨临床治疗经验与体会。方法 对1991～2003-12收治的16例全头皮撕脱伤患者临床资料进行总结分析,重点探讨各治疗方法的适应证。结果 受伤者多为年轻女性,主要因头发绞入转动的机器所致。在治疗方法选择上,有条件再植的行血管吻合术,不能再植而骨膜完整者植皮为首选方法;颅骨外露首选方法是凿除颅骨外板直接植皮,也可采用游离肌瓣移植加植皮的方法覆盖创面。游离大网膜移植和钻孔引髓、生长肉芽后再植皮的方法有其缺点。结论 全头皮撕脱伤创面处理应根据患者伤情特点来确定,颅骨外露处理有多种方法,各有优劣。Objective To review clinical data of scalp avulsion injury, and to summarize experiences in the management of the injury. Methods This article deals with 16 scalp avulsioons treated by the authors in the last 12 years. Results The victims were predominantly young females and mainly owing to their hair caught up in moving machine. Various modalities of treatment are discussed. If it is possible to replant, one should try to anastomose the vessels. With intact periosteum, split - skin grafting remains the treatment of choice. In the presence of bare bone local flap is preferred when feasible, otherwise chiseling outer table of the skull with immediately spilt - skin grafting is first choice. Omentum transplantation and multiple drilling in outer table of skull to accelerate the formation of granulation tissue, followed by spilt - skin grafting can be used, but they bear disadvantages. Conclusion There are several techniques one can use to manage scalp avulsion injury.

关 键 词：头皮撕脱 手术方案 适应证 血管吻合术 皮肤移植术 致伤原因 

分 类 号：R622.1[医药卫生—整形外科]