手部热压伤的早期修复(附43例报告)

目的 探讨早期清创、组织修复在热压伤治疗中的临床疗效。方法 分析43例不同程度手部热压伤患的病损特点并行临床分度，以便准确诊治、判断预后；全部病例采用早期手术治疗，轻度热压伤(即浅Ⅲ度烧伤)早期行切痂全厚或中厚皮片修复，中度和重度热压伤早期彻底清创保留间生态组织，应用血循环丰富的组织瓣修复创面。结果 42例创面一期修复，手功能和外形恢复满意：1例创面二期修复，手功能恢复差。结论 手部热压伤应早期手术清创，据病损程度选择良好的方法及时修复组织缺损，可最大限度地恢复手功能和外形，减少致残率，缩短疗程，获得较好的临床疗效。

The Early Reconstruction of Hand Hot-crush Injury (A Report of 43 Cases)

Objective To study the clinical results of early debridement with immediate reconstruction of the tissue defect for hand hot crush injuries. Methods The characteristics of the pathologic damage of various degree hot crush tissues in 43 patients were analyzed, and the clinical grade of each injury was classified accordingly. All the cases underwent early operative treatment. The cases of mild degree (superficial third degree burn) underwent escharectomy and split or full thickness skin grafting. The cases of moderate or severe degree received early thorough debridement with reservation of the somewhat living tissue, the defect was then reconstructed by transplantation of compound tissue flap. Result The raw surface of 42 cases who got primary repair had good result. One case received secondary repair of the defect, and the function and shape of the hand was not ideal. Conclusion Early debridement and immediate reconstruction of the tissue defect is ideal for treatment of different pathologic damage of hand hot crush injury. It will reduce the disability rate and shorten the therapeutic course.