CAJ | 학술논문

目的:探讨亚急诊修复四肢软组织缺损的可行性。方法:本院于1990～1999年共收住403例四肢软组织缺损病人，运用带蒂皮瓣、游离皮瓣及植皮方法在不同时期进行修复，其中急诊手术124例，亚急诊（急诊清创后1～5天）手术163例，晚期（5天以后）手术116例。同时对三组病例术后感染率、皮瓣坏死率及功能恢复情况进行统计研究。结果: 亚急诊手术感染率为3.7%，急诊手术感染率为3.2%，晚期手术感染率为3.4%；吻合血管的游离皮瓣移植病例，亚急诊手术坏死率为4.8%，急诊手术坏死率为8.3%，晚期手术坏死率为7. 4%。三组病例术后感染率、游离皮瓣移植术后坏死率差异无显著性（P >0.05）。114例单纯手背皮肤缺损行皮瓣修复术后手指活动功能比较结果显示，亚急诊手术优良率为87.2%，急诊手术优良率为90.5%，晚期手术优良率为64.0%。亚急诊与急诊病例术后功能优良率差异无显著性（P>0.05），而与晚期病例差异有显著性（ P<0.05），前者优于后者。结论: 亚急诊期为急诊清创后1～5天较妥，此时修复四肢软组织缺损能兼顾急诊和晚期手术的利弊，临床实施安全可靠。
목적:탐토아급진수복사지연조직결손적가행성。방법:본원우1990～1999년공수주403례사지연조직결손병인，운용대체피판、유리피판급식피방법재불동시기진행수복，기중급진수술124례，아급진（급진청창후1～5천）수술163례，만기（5천이후）수술116례。동시대삼조병례술후감염솔、피판배사솔급공능회복정황진행통계연구。결과: 아급진수술감염솔위3.7%，급진수술감염솔위3.2%，만기수술감염솔위3.4%；문합혈관적유리피판이식병례，아급진수술배사솔위4.8%，급진수술배사솔위8.3%，만기수술배사솔위7. 4%。삼조병례술후감염솔、유리피판이식술후배사솔차이무현저성（P >0.05）。114례단순수배피부결손행피판수복술후수지활동공능비교결과현시，아급진수술우량솔위87.2%，급진수술우량솔위90.5%，만기수술우량솔위64.0%。아급진여급진병례술후공능우량솔차이무현저성（P>0.05），이여만기병례차이유현저성（ P<0.05），전자우우후자。결론: 아급진기위급진청창후1～5천교타，차시수복사지연조직결손능겸고급진화만기수술적리폐，림상실시안전가고。
Objective：To explore the possiblity of sub-emergent repair of the soft tissue defects. Methods：From 1990 to 1999, 403 cases with the soft tissu e defects in the four limbs were repaired by the pedicled flaps, free flaps, and full-thickness or split-thickness grafting. 124 of them were repaired emergently, 163 of them were repaired subemergently, 11 6 of them were repaired in late-stage. A retrospective analysis has been made. Results：The necroses rate, infection rate of subemergent repair did not show difference from the other groups（P >0.05）. Their function was better than that in the later period repai red cases（P<0.05）. Conclusion：Subemergent repair gives enough consideration to t he advantages of emergent repair and the disavantages of late-stage r epair. It is safety in clinical application.