CAJ | 학술논문

目的探讨地震伤员开放伤口的手术处理方法.方法总结5· 12汶川地震中于2008年5月12-26口转入华西医院骨科接受手术治疗的51例开放伤口伤员的术前情况、手术治疗方法及术后效果.51例中,开放骨折8例,切开减张创面6例,骨外露8例,单纯皮肤软组织缺损29例.创面感染率100％.共进行60次手术,手术方法:皮瓣、肌皮瓣手术4例,植皮术30例(包括邮票植皮、整张植皮和网状植皮),创面负压引流治疗(NPWT)2例,扩创术24例.结果 4例皮瓣、肌瓣手术后皮瓣、肌瓣成活良好；30例植皮手术皮片成活率均达到90％以上；2例NPWT、24例扩创术后创面感染减轻,继续换药处理或择期手术.结论恰当的创面手术处理方法可以加速地震伤员开放创面的愈合、最大限度地保存功能.
목적 탐토지진상원개방상구적수술처리방법.방법 총결5· 12문천지진중우2008년5월12-26구전입화서의원골과접수수술치료적51례개방상구상원적술전정황、수술치료방법급술후효과.51례중,개방골절8례,절개감장창면6례,골외로8례,단순피부연조직결손29례.창면감염솔100％.공진행60차수술,수술방법:피판、기피판수술4례,식피술30례(포괄유표식피、정장식피화망상식피),창면부압인류치료(NPWT)2례,확창술24례.결과 4례피판、기판수술후피판、기판성활량호；30례식피수술피편성활솔균체도90％이상；2례NPWT、24례확창술후창면감염감경,계속환약처리혹택기수술.결론 흡당적창면수술처리방법가이가속지진상원개방창면적유합、최대한도지보존공능.
Objective To explore the surgical managements of open wounds from 5 · 12 Wenchuan Earthquake.Methods In this report,fifty one patients with open wounds were treated after transported into West China Hospital from May 12 to 26 in 2008 after 5 · 12 Wenchuan Earthquake.Among 51 cases,open wounds were due to open fractures (n =8),fasciotomy (n =6),exposed bone (n =8) and defects of skin and soft tissue (n =29).All cases had wound infections.Sixty operations were performed,including muscle and myocutaneous flap ( n =4 ),skin grafting ( n =30 ),NPWT ( negative pressure wound therapy ) ( n =2 )and debridement ( n =24 ). Results Four cases of muscle and myocutaneous flaps survived with an excellent blood circulation.And 30 cases of skin grafting had a survival rate of over 90％,2 cases of NPWT and 24 cases of debridement required further treatment.Conclusion With adequate surgical managements,open wound healing from an earthquake may be accelerated and the functions maximally preserved.