儿童交通伤致下肢皮肤撕脱伤特点及处理  

The behavior and the treatment for severe avulsion of skin of lower limbs of children

作　　者：邱林[1] 傅跃先[1] 田晓菲[1] 刘燕[1] 

机构地区：[1]重庆医科大学附属儿童医院烧伤整形科,400014

出　　处：《重庆医学》2005年第2期188-189,共2页Chongqing medicine

摘　　要：目的探讨儿童交通伤所致严重下肢皮肤撕脱伤特点及适当处理方法.方法分析总结儿童交通伤严重下肢皮肤撕脱伤及合并损伤24例,分别采用清创撕脱皮肤缝合、带蒂真皮下血管网皮瓣回植、撕脱皮肤全厚皮片回植及同期合并伤处理等方法.结果清创撕脱皮肤缝合8例,2例1期愈合,4例10%～80%撕脱皮肤及皮下组织坏死,2例完全坏死,补植皮后痊愈.带蒂真皮下血管网皮瓣回植12例,3例Ⅰ期愈合;10例10%～50%回植皮瓣坏死,补植皮后痊愈.1例全厚撕脱皮片回植,边缘少量皮片坏死.随访5个月～2年,无明显的下肢活动障碍,外形尚可.结论在儿童交通伤严重下肢皮肤撕脱伤及合并其他损伤急诊处理中,根据撕脱皮肤血供、严重程度选择相应的处理方式,可最大限度减少皮肤坏死、保存和利用组织以利于下肢外形及功能的恢复.Objective To investigate the behavior and the appropriate treatment for severe avulsion of skin of lower limbs of children.Methods Twenty-four cases,who were severe avulsion of skin of lower limbs and those with fractur, injury of urethra or ano-rectum,were treated with debridement and suturing, subdermal vascular network skin flap with pedicel which is made up of the clipped split-thickness skin, full thick skin graft.Results The necrosis area of the split-thickness skin was from 0%~100% in 8 cases treated with debridement and suturing, 0%~50% in 12 cases treated with subdermal vascular network skin flap with pedicel and about 5% in 1 case treated with full thick skin graft.Conclusion When treating the severe avulsion of skin of lower limbs of children, the necrosis area of the split-thickness skin can be reduced to a large extent according to the blood supply well or not.

关 键 词：儿童 下肢 皮肤撕脱伤 血供 

分 类 号：R726.5[医药卫生—儿科]