局部邻近皮瓣手深度烧伤创面对手功能恢复的影响

目的探讨局部邻近皮瓣修复手深度烧伤创面对手功能恢复的影响。方法总结我科1990年1月到2007年12月手深度烧伤病人70例，其中34例采用邻近皮瓣修复手深度烧伤（治疗组）；36例采用腹部带蒂皮瓣修复手深度烧伤（对照组）。出院时测量手指关节总活动度（TAM）和记录住院时间，分析这两种方法对病人手功能恢复程度以及住院时间的影响。结果治疗组32例皮瓣-期愈合，2例皮瓣尖端部分坏死，经换药后愈合，平均住院时间18．95±5．22d，较腹部带蒂皮瓣住院时间29．45±6．78d缩短10天左右（P〈0．05）；治疗组术后手的外形和功能恢复良好，其TAM为189．55°±33．67°，对照组为123．47°±23．81°，两组比较差异有显著性（P〈0．05）。结论局部邻近皮瓣是一种十分有效的修复手部深度烧伤创面的方法，创面愈合早，有利于手各关节早期锻炼和功能恢复。

The adjacent skin flap repairing third degree burns of hand

Objective To investigate the therapeutic efficacy of the adjacent skin flap repairing third degree burn of hand. Methods We have summarized 70cases of hospital patients with third-degree burn on hands from January 31, 1990 to December 31, 2007, as a result, 34cases of the total were repaired by the adjacent skin flap (treat group), and 36cases of the total were repaired by the pedicle skin flap of the belly (control group). Based on the test of finger joints functional recovery of hands (TAM) at discharge, and hospitalized time, we analyzed how both methods effected on functional recovery of hands and the length of hospitalizing.Results In treat group, 32 cases of skin flaps were primarily healed, however, in 2 cases the ends point of skin flap were partly necrosis, after further treatment, they were healed at last. In the treat group the average hospital stay is 18.95±5.22days(P<0.05), TAM is 189.55°±33.67°(P<0.05); In the control group the average stay is 29.45±6.78d and the TAM is 123.47°±23.81°. The average stay and the TAM are significant difference between 2 groups.Conclusion The adjacent skin flap is a very effective method that repairs the hand deep burn. The wound heals significantly faster witch enable the patients to start early exercise with all hand joints and also start rehab on functional recovery as fast as possible.