清创结合负压封闭引流技术治疗手部高压油漆注射伤

目的：探讨负压封闭引流（VSD）技术对手部高压油漆注射伤创面的修复作用及评价疗效。方法：自2005年4月至2010年8月,采用清创结合VSD技术治疗手部高压油漆注射伤14例,年龄23～47岁,平均36.5岁,均为男性,均为左手受伤,拇指5例,食指3例,中指2例,手掌4例。患手肿胀明显,末梢血运差。所有患者在伤后6h内急诊行清创探查及VSD封闭创面,经3～4次手术,待创面肉芽组织新鲜,无明显炎性渗出后,行植皮（9例）或转移皮瓣（5例）修复创面。结果：14例患者均获得随访,时间8～16个月,平均12个月。所有创面均愈合良好。根据TAM功能评定法评价：优7例,良6例,中1例。结论：清创结合VSD技术能够有效避免伤口感染,促进肉芽组织生成,有利于创面修复。

Treatment of high-pressure paint injection injuries of hand with debridement combined with vacuum sealing drainage technique

Objective: To explore the effects of debridement combined with vacuum sealing drainage(VSD) technique in treatment of high-pressure paint injection injuries of hand.Methods: From April 2005 to August 2010,14 patients with high-pressure paint injection injuries of hand were treated with debridement and VSD technique within 6 hours after injury.All the patients were male,ranging in age from 23 to 47 years with an average of 36.5 years.All injuries occurred left hand,thumb injured in 5 cases,index finger in 3 cases,middle finger in 2 cases and palm in 4 cases.Injured hands swelled obviously with poor blood circulation.When the wounds were covered with fresh granulation tissue without inflammatory effusion after operation of 3-4 times,the skingrafting (9 cases) or transfer flap (5 cases) were done on the wounds.Results: All the patients were followed up from 8 to 16 months with an average of 12 months.All the wounds obtained good healing.Therapeutic effects were estimated according to TAM criteria,7 cases were excellent,6 good and 1 fair.Conclusion: In high-pressure paint injection injuries of hands,debridement combined with VSD technique can avoid wound infection,promote the growth of granulation tissue.It is beneficial to wound healing.