中厚皮片超时原位植皮治疗全头皮撕脱伤

目的回顾受伤超过15h以上的全头皮撕脱伤的手术治疗,总结其再植要点及临床意义.方法7例全头皮撕脱在15h以上,面积达8cm×8cm～18cm×25cm,同时伴有休克和颅脑外伤者,通过将撕脱的头皮制成中厚皮片原位回植,覆盖头部创面.结果术后6例回植头皮片100%成活,1例回植头皮片80%以上成活,颅骨裸露区行外板钻孔,二期自体中厚皮片植皮后成活.结论治疗只要处理适当,注意再植要点,可以放宽中厚皮片回植的条件,延长撕脱头皮的利用时间.中厚皮片超时原位植皮是治疗全头皮撕脱伤的适宜方法.

Treatment of Overtime Total Scalp Avulsion by Replanting Split Thickness Skin Grafts in Situ

Objective To review a treatment method of scalp avulsion injury,which had been wounded more than 15 hours,and summarize its clinical significance and the main points of the replantation procedure.Methods Form January 1996 to March 2009,we treated 7 cases of avulsed scalp,which had been wounded more than 15 hours,covering an area of 8 cm×8 cm～18 cm× 25 cm and accompanied with shock and head wound,with the split thickness skin grafts from avulsed scalps transplanted to wounds.Results Of all,the total scalp survived in 6 cases,80% survived in 1 who was treated with staged Ⅱ medium and thick flap plantation after the bare area covered granulation tissue.Conclusions The limits of time of scalp skin grafting will be prolonged as long as the processes are settled properly and summarizing the main points of the replantation procedure.It might be a suitable method to treat overtime total scalp avulsion by replanting split thickness skin grafts in situ.