手背深度烧伤削痂延期植皮和立即植皮手术疗效比较

目的分析对比手背深度烧伤切削痂后进行延期植皮手术和立即植皮手术的效果和优缺点。方法2000年以来收治的手背深度烧伤106例分为手背削痂延期植皮组和立即植皮组。延期植皮组手背切削痂后创面抗生素湿敷,厚敷料包扎固定,2～3d后第二次手术植皮。立即植皮组一次手术完成切削痂和植皮。比较两组的手术时间、创面细菌量、植皮成活率、皮下血肿率、并发症、费用、后期手功能等。结果延期植皮组的手术时间短,创面细菌无增加,皮片成活率和优秀率高,皮下血肿发生率低,后期手功能恢复好。结论手背深度烧伤削痂后延期植皮术具有缩短手术时间、减少臂丛神经损伤、安全、植皮成活率高、皮下血肿少等诸多优点,是一种比较好的手术选择,综合效果优于立即植皮。

Comparison between therapeutic effects of immediate or delayed skingrafting for deep burn on the dorsum of hands

Objective To compare the effects and advantages of delayed and immediate skingrafting for deep burn on the dorsum of hands.Methods 106 burn patients who had deep burn on the hands were divided into two groups:delayed skingrafting group(A group) and instantly skingrafting group(B group).The patients in group A(n=56) first underwent the burn wound excision-then skingrafting operation were done two-three days later.The patients in group B(n=50) immediately underwent the burn wound excision and skingrafting. The operation time-wound bacterium-skingrafting survival rate-subcutaneous hematoma rate- complications- operation cost and postoperative hand function were investigated and recorded.Results The operation time in group A was much shorter than those in group B.Moreover-there was no difference of the wound bacterium between the two groups.In addition- the rate of skingrafting survival and hand function in group A were more excellent than those in group B.Conclusion Delayed skingrafting for burn on the dorsum of hands is proved to be effective in reducing operation time- the rates of brachial plexus injury and subcutaneous hematoma.The authors recommmend this kinds of operation for hand deep burn patients.