手背深度烧伤早期切痂植皮的经验

目的总结手背深度烧伤(深Ⅱ度和Ⅲ度)的治疗经验。方法选择98例有手背深度烧伤(深Ⅱ度和Ⅲ度)的患者进行了早期切痂植自体中厚皮移植术。小面积烧伤伤后当天手术;较大面积者伤后2～5d手术。均选用切痂后立即植皮。切痂范围一般指端达第二或第三指节;近端应过腕部;两侧以达到切除焦痂为目的。切痂时切勿暴露深层健康肌腱和骨质,特别注意掌指关节和第一指间关节处。切口采用曲折线,避免直线。植皮采用整张的自体皮片。术中若止血不彻底疑有血肿形成或有感染迹象时,应于术后2～4d更换1次敷料结果98例手背深度烧伤创面,全部1次治愈,创面平均愈合时间17.05d。结论手背深度烧伤创面早期切痂植皮安全可行,能缩短创面平均愈合时间,有效地挽救功能,减少瘢痕畸形。

Experiences in Early Crust Incision and Skin Graft for Deep Burn of Hand Dorsa

Objective To summarize the therapeutic experiences in deep burn of hand dorsa. Methods Early crust incision and autogenous split-thickness skin graft were performed onto 98 patients with deep burn of hand dorsa. Operations were performed the same day on the patients with small burn, and 2~5 days later on those with large burn. All the patients were given crust incision and immediate skin graft. Results All the 98 patients were healed up with one time's operation, and the wound healing time was averagely 17.05 days. Conclusion It is safe and doable that early crust incision and skin graft are performed onto the wounds of those who suffered from deep burn on the backs of the hands, for the average healing time can be shortened and the hand function can be effectively saved.