Effective administration of cranial drilling therapy in the treatment of fourth degree temporal,facial and upper limb burns at high altitude:A case report  

作　　者：Cong-Mo Shen Yi Li Zhou Liu Yong-Zhang Qi 

机构地区：[1]Department of Burns and Plastic Surgery,Affiliated Hospital of Qinghai University,Xi’ning 810016,Qinghai Province,China [2]Department of Cardiology,Affiliated Hospital of Jiangnan University,Wu’xi 214000,Jiangsu Province,China

出　　处：《World Journal of Clinical Cases》2020年第20期5062-5069,共8页世界临床病例杂志

摘　　要：BACKGROUND Fourth degree burns damage the full thickness of the skin and affect underlying tissues.Skin grafting after debridement is often used to cover the wounds of salvageable severe burns.A granulation wound can be formed by drilling the skull to the barrier layer to solve the problem of skull exposure.Low oxygen levels present at high altitudes aggravate ischemia and hypoxia which can negatively impact wound healing.The impaired healing in such cases can be ameliorated by hyperbaric oxygen therapy.CASE SUMMARY We describe a patient who presented with fourth degree burns to the left temporal and facial regions upon admission in December 2018.The periosteum of the skull and the deep fascia of the face were exposed.After the first stage of debridement and skin grafting,the temporal skin did not survive well.Granulation was induced by cranial drilling,and then a local flap was transferred to cover the wound.The left temporal and facial wounds were completely covered and the patient recovered well.CONCLUSION Skin grafting and flap transfer after early debridement to cover the wound and control infection were of great significance.In the later stages of the patient's treatment,survival of the skin graft and skin flap was observed.The second stage repair was performed to achieve successful skin grafting by cranial granulation.Granulation was formed by drilling the skull,and then the wound was closed,which is suitable for cases with skull exposure and wounds with poor blood supply.We consider that hyperbaric oxygen treatment and improving tissue oxygen supply were beneficial in this patient.

关 键 词：Fourth degree burn Skull exposure Chronic wounds Cranial drilling therapy High altitude area Case report 

分 类 号：R644[医药卫生—外科学]