手部爆炸伤二种创面的不同处理  

EXPERIENCE OF TWO DIFFERENT TREATMENT OF THE WOUND OF HAND BLAST INJURY

作　　者：邢长胜[1] 李光明[1] 王永富[1] 卢顺平[1] 原堔鸥[1] 

机构地区：[1]焦作煤业集团中央医院骨四科,河南省焦作市454100

出　　处：《中国煤炭工业医学杂志》2011年第12期1765-1766,共2页Chinese Journal of Coal Industry Medicine

摘　　要：目的回顾性分析15例手部爆炸伤的临床处理。方法根据手部爆炸伤污染程度不同,采用急诊清创一期皮瓣修复7例,创面敞开换药或清创延期行皮瓣修复5例,一次彻底清创缝合闭合创口2例,一期全厚皮片打包植皮1例。结果随访6～12月,2例患者术后患指慢性炎症长时间肿痛,最后二期手术行病灶清除皮瓣修复症状消失;1例患者因腱鞘内感染,给予切开引流并应用抗生素后痊愈;其余均痊愈。结论对于烟花爆竹及矿山爆炸所致的手部外伤,应根据患者创口创面的不同特点,采用不同的清创修复重建方法,严格彻底的清创直接关系到患者的愈合。Objective The clinical treatment of 15 patients with blast injuries ,n the nana were retro- spectively analysed. Methods According to pollution degree of hand explosion injury, adopt emergency debridement and skin flap transposition in 7 cases for the first phase, opening the wound,, dressing change or debriding for delay skin flap in 5 cases, a thorough debridement suturing wound in 2 cases, all thick skin piece packing graft in one. Results Followup of 6 to12 months, for a long time fingers swelling and paining postoperatively because of chronic inflammation in 2 cases , Symptoms disappeared after clearing Lesions and skin flap to repair; one case infecting in tendon sheath, healed after giving incision and drainage and antibiotics; The rest were healed. Conclusion Hand injury caused by fireworks and mine explosion, should according to different characteristics of the wound in patients, using different method for debriding and repairing; It is strictly thoroughly debriding to directly relate to healing of patients.

关 键 词：爆炸伤 手外伤 清创 

分 类 号：R642.05[医药卫生—外科学]