CAJ | 학술논문

目的：分析手外科开放性创伤带蒂腹股沟皮瓣术后皮瓣发生感染坏死的原因，并寻找预防对策。方法：统计我院手外科2012年1月-2014年12月手外伤行带蒂腹股沟皮瓣术139例，其中男106例，女33例，年龄12～60岁，平均（37.28±4.72）岁，分析导致皮瓣坏死的原因，总结预防皮瓣坏死的相关措施。结果：入组患者中有5例术后早期发生并发症，发生率为3.59%，其中2例皮瓣边缘部分发生坏死，发生率1.44%，3例伤口发生感染，发生率2.15%，皮瓣部分坏死者通过积极地三抗治疗（抗炎、抗凝、抗痉挛）及伤口换药等处理，皮瓣最终全部成活。伤口感染者通过积极地抗感染治疗及伤口清创换药治疗，最终痊愈。结论：冲洗清创、皮瓣设计、体位及制动、手术操作、术后引流、环境及营养、术后抗感染治疗等影响到手外伤腹股沟带蒂皮瓣修复术后皮瓣感染及坏死的发生，要降低皮瓣感染坏死的发生率，应在围手术期针对前述影响因素给予妥善处理。
목적：분석수외과개방성창상대체복고구피판술후피판발생감염배사적원인，병심조예방대책。방법：통계아원수외과2012년1월-2014년12월수외상행대체복고구피판술139례，기중남106례，녀33례，년령12～60세，평균（37.28±4.72）세，분석도치피판배사적원인，총결예방피판배사적상관조시。결과：입조환자중유5례술후조기발생병발증，발생솔위3.59%，기중2례피판변연부분발생배사，발생솔1.44%，3례상구발생감염，발생솔2.15%，피판부분배사자통과적겁지삼항치료（항염、항응、항경련）급상구환약등처리，피판최종전부성활。상구감염자통과적겁지항감염치료급상구청창환약치료，최종전유。결론：충세청창、피판설계、체위급제동、수술조작、술후인류、배경급영양、술후항감염치료등영향도수외상복고구대체피판수복술후피판감염급배사적발생，요강저피판감염배사적발생솔，응재위수술기침대전술영향인소급여타선처리。
Objective To analysis the causes of infection and necrosis in hand injury pedicled groin flap and explore its preventive measures. Methods A total of 139 hand injury patients who accepted pedicled groin flap treatment from January 2012 to December 2014 were included,in which of them there were 106 male and 33 female,with a average age of 37.28 ± 4.72 (range 12-60) years. The causes and preventive measures of flap necrosis were analyzed and summarized. Results There were five patients appeared with early postoperative complications which accounted for 3.59%, in which of them there were two cases of marginal necrosis and three cases of wound infection accounting for rate 1.44% and 2.15% respectively.The flaps with marginal necrosis were finally survived by the active treatment of three anti- therapy (anti-inflammatory, anti- coagulation,anti-spasm) and wound dressing.The flaps with infection were survived by the treatment of anti infection and wound dressing. Conclusion The occurrence of infection and necrosis in hand injury pedicled groin flap were affected by wound irrigation and debridement, flap design,postur and immobilization, surgical methods, postoperative drainage,environment and nutrition and postoperative anti-infective therapy. All the influential factors mentioned above must be handled properly in order to reduce the incidence of necrosis and infection of the flaps.