铡草机致手外伤感染的治疗

目的 分析和总结铡草机所致手外伤感染的治疗方法及疗效.方法 对25例2008年6月-2013年1月对我科收治的铡草机所致手外伤感染患者,一期采用封闭式负压引流术（vacuum sealing drainage,VSD）、“三黄汤”中药换药、清创扩创术控制感染;二期分别行皮瓣修复、游离植皮、残端修整减张缝合术修复创面.结果 本组25例,经一期治疗后3例无感染出现,22例感染得到良好控制,二期行修复术.术后22例获得随访,随访时间为6～12个月,平均10个月,无感染复发.结论 一期彻底清创,VSD覆盖创面,再次出现感染者可二次使用VSD,且炎症早期采用“三黄汤”中药换药,同时监测化验感染指标,选择敏感抗生素足量全程治疗,可有效降低铡草机致手外伤感染的发生率.

Treatment of hand infection cause by ensilage machine

Objective To analyse and summarize the treatment method for hand infection due to ensilage machine injury.Methods From June,2008 to January,2013,25 patients with hand infection caused by ensilage machine were treated.The infection was controlled by using respectively vacuum sealing drainage,Sanhuang Decoction Chinese medical dressing change,and debridement.In the second period,the surface of the wound was renovated by skin flap repairing,free skin grafting,residual modification and relaxed suture.Results In 25 cases,3 cases without infection,22 cases got good control and renovated in the second phase.22 cases were followed-up for 6 to 12 months,an average of 10 months,no recurrence of infection.Conclusion Thoroughly debride and in phase Ⅰ and VSD overlaid the surface of wound can avoid the hand infection due to agricultural machine as far as possible.If it become infected,using VSD again or treat with chinese medicine in inflammation early,at the same time monitor laboratory indicators of infection,all can effectively decreased the infection ratio of hand injuried.