中华损伤与修复杂志（电子版）
中華損傷與脩複雜誌（電子版）
중화손상여수복잡지（전자판）
Chinese Journal of Injury Repair and Wound Healing
2012年
2期
49-51,76
,共4页
梁茶%彭云%庄君灿%谭文源
樑茶%彭雲%莊君燦%譚文源
량다%팽운%장군찬%담문원
创伤和损伤%皮肤移植%伤口感染%急诊处理
創傷和損傷%皮膚移植%傷口感染%急診處理
창상화손상%피부이식%상구감염%급진처리
Wounds and injuries%Skin transplantation%Wound infection%Emergency treatment
目的 总结严重大面积皮肤撕脱复合伤感染坏死创面的修复方法.方法 对1996年1月至2011年6月江门市人民医院收治严重大面积皮肤撕脱复合伤合并创面感染坏死21例,采取彻底清除坏死组织,充分引流,对肉芽创面及坏死感染程度相对较轻创面予自体皮片移植,坏死感染较严重及创面较深者采用负压引流技术,合并有肌腱和骨外露创面则利用皮瓣、肌皮瓣或游离皮瓣移植修复创面.结果 本组21例46个创面经分次手术后全部治愈.其中应用负压引流技术9例次,自体皮片移植55例次,局部皮瓣转移26例次,阔筋膜张肌肌皮瓣转移13例次,阴股沟皮瓣转移6例次.除5例次移植皮瓣远端部分坏死外,其余均成活良好.创面完全愈合时间为31～102d,平均(48.10±12.14)d.结论 严重大面积皮肤撕脱复合伤急症处理要及时合理,彻底清创和充分引流是防止创面进一步恶化的关键,选择正确的修复方法可促进感染坏死创面早日愈合,有效改善功能与外观.
目的 總結嚴重大麵積皮膚撕脫複閤傷感染壞死創麵的脩複方法.方法 對1996年1月至2011年6月江門市人民醫院收治嚴重大麵積皮膚撕脫複閤傷閤併創麵感染壞死21例,採取徹底清除壞死組織,充分引流,對肉芽創麵及壞死感染程度相對較輕創麵予自體皮片移植,壞死感染較嚴重及創麵較深者採用負壓引流技術,閤併有肌腱和骨外露創麵則利用皮瓣、肌皮瓣或遊離皮瓣移植脩複創麵.結果 本組21例46箇創麵經分次手術後全部治愈.其中應用負壓引流技術9例次,自體皮片移植55例次,跼部皮瓣轉移26例次,闊觔膜張肌肌皮瓣轉移13例次,陰股溝皮瓣轉移6例次.除5例次移植皮瓣遠耑部分壞死外,其餘均成活良好.創麵完全愈閤時間為31～102d,平均(48.10±12.14)d.結論 嚴重大麵積皮膚撕脫複閤傷急癥處理要及時閤理,徹底清創和充分引流是防止創麵進一步噁化的關鍵,選擇正確的脩複方法可促進感染壞死創麵早日愈閤,有效改善功能與外觀.
목적 총결엄중대면적피부시탈복합상감염배사창면적수복방법.방법 대1996년1월지2011년6월강문시인민의원수치엄중대면적피부시탈복합상합병창면감염배사21례,채취철저청제배사조직,충분인류,대육아창면급배사감염정도상대교경창면여자체피편이식,배사감염교엄중급창면교심자채용부압인류기술,합병유기건화골외로창면칙이용피판、기피판혹유리피판이식수복창면.결과 본조21례46개창면경분차수술후전부치유.기중응용부압인류기술9례차,자체피편이식55례차,국부피판전이26례차,활근막장기기피판전이13례차,음고구피판전이6례차.제5례차이식피판원단부분배사외,기여균성활량호.창면완전유합시간위31～102d,평균(48.10±12.14)d.결론 엄중대면적피부시탈복합상급증처리요급시합리,철저청창화충분인류시방지창면진일보악화적관건,선택정학적수복방법가촉진감염배사창면조일유합,유효개선공능여외관.
Objective To summarize the treatment methods of severe large area of skin avulsion injury complicated with infected and necrotic wound.Methods Twenty-one cases of severe large area of skin avulsion injury complicated with infected and necrotic wound were admitted to People' s Hospital of Jiangmen from January 1996 to June 2011.Necrotic tissues were debrided and discharge was drained.Wound with granulation and less infection and necrosis were auto-grafted.Negative pressure drainage was applied to deep wound and wound with severe infection and necrosis.Wound with tendons and bones exposure were grafted with skin flaps,myocutaneous flaps or free skin flaps.Results Forty-six wounds within 21 cases healed well after surgery by stages.Nine negative pressure drainage was applied.There were 55 skin auto-grafting,26 local flaps transplantation,13 tensor fasciae latae myocutaneous transplant and 6groin skin flaps transplantaion.All grafts survived except 5 partial distal flaps necrosed.Wound healing time was 31 to 102 days with average 48.10 ± 12.14 days.Conclusions Severe large area of skin avulsion injury should be treated promptly.Debridement and drainage are crucial to prevent worsening of wound.Infected and necrotic wound could be healed shortly with correct methods of treatment.The function and appearance could be improved effectively.
