摘要
目的探讨下肢严重皮肤撕脱伤的功能挽救方案。方法2000年12月～2005年6月,对68例因交通伤所致的下肢严重皮肤撕脱伤患者,在彻底清创基础上,进行骨折固定、血管神经修复,然后采用四种处理方法进行创面皮肤覆盖:⑴皮肤原位缝合;⑵急诊植皮或皮瓣移植修复;⑶延迟一期修复,即急诊清创后观察3～7天,再进行第二次清创,采用植皮或皮瓣修复创面;⑷晚期处理,对因一期处理不当致皮肤坏死或形成皮下囊肿病例采用再次返削植皮。结果所有肢体均成活。本组病例随访6个月～5年,皮肤创面均完全覆盖。优:肢体外形好,膝关节、踝关节活动在正常范围,足部血运及感觉正常,38例;良:肢体外观正常,膝、踝关节活动有不同程度受限,足部血运及感觉正常,23例;差:肢体变细,膝、踝关节活动范围有不同程度受限,足部血运及感觉正常,7例;优良率89.7%。结论准确判断脱套伤所累及组织的伤情,安排周密的术前计划,树立全程康复观念以及合理选用创面修复方法,是确保脱套伤肢体功能获得最大程度恢复的关键。
：Objective To study the Restorating of Severity extensive avulsed injuries in lower limbs caused by traffic accidents.Methods The treatment of 68 patients were retrospectively reviewed, based on debridement, fixation of bone fracture and repairing of vascular nerve were performed, four methods were adopted to repair raw surface.Results The lower limbs of Severity extensive avulsed injuries were survival. The follow-up was 6 months to 5 yeats, all cases healed well, and excellent in 38 cases, good in 23 cases, bad in 7 cases, the overall excellent and good rate was 87.9% .Conclusion Evaluation of the severity of the injury, carefully preoperative planning, rehabilitation concept and choice of the correct repair are the key points for successful treatment.
出处
《实用手外科杂志》
2007年第2期73-76,F0003,共5页
Journal of Practical Hand Surgery
关键词
下肢
皮肤撕脱伤
交通事故
皮瓣
Lower limbs
Avulsed injury
Traffic accident
Flap
