早期分区切(剥)痂植皮修复头面部硫酸烧伤  

Management of Scalp and Facial Burns by Sulphuric Acid With Early Escharectomy or/and Peeling of Eschar and Zoning Skin Grafting

作　　者：苏顺清 戴新明 覃谦 

机构地区：[1]广东省东莞市东华医院烧伤整形科,广东东莞523013

出　　处：《中国医师杂志》2003年第5期608-609,共2页Journal of Chinese Physician

摘　　要：目的　探讨头面部硫酸烧伤创面早期分区修复的手术方式和时机。方法　头面部深度创面早期分区手术 :⑴上面部(额、颞、上睑 )深度创面早期 (伤后 1～ 4d)切痂 +自体全 (中 )厚皮移植 ;⑵ )面颊部深度创面早期 (伤后 9～ 12d)行剥痂 +自体中厚皮移植 ;⑶头部创面可根据深度创面范围、形状分别行头皮扩张术或后期肉芽创面植皮术。结果　本组 6例创面修复效果满意 ,移植皮片平坦 ,瘢痕增生不明显 ;3例头皮扩张术一期修复头皮创面 ,避免了瘢痕性秃发的发生。结论　应用早期分区切 (剥 )痂植皮手术 ,可促进创面早期修复 ,防止瘢痕过度增生 ,并可减轻头面部畸形和避免瘢痕性秃发。Objective To explore optimal methods and an opportunity of the management of scalp and facial burns caused by sulphuric acid,so as to prevent the development of facial hypertrophic scar and deformity. Methods Early zoning management were carried out in burn patients by sulphuric acid : ⑴Early (postburn 1～4 days) escharectomy and full or split thickness skin grafting were carried out in up-facial( forehead,temporal and up eyelid) ; ⑵Early(postburn 9～12 days) peeling of eschar and split thickness skin grafting were applied in cheek. ⑶Scalp expansion or skin grafting in granulation laterly in scalp wound according its shape and area.Results The wounds in 6 cases had healed comfortably ,hypertrophic scar and facial deformity were not occurred during the followed-up.3 cases of scalp burns scarring baldness were avoided.Conclusion Scalp and facial burns by sulphuric acid could be managed as early escharectomy and peeling of eschar and zoning skin grafting.As result,facial scar hypertrophy and deformity could be avoided.

关 键 词：头面部损伤 硫酸烧伤 切(剥)痂 皮肤移植 

分 类 号：R622[医药卫生—整形外科]