手部深度烧伤的临床治疗分析

目的 总结手部深度烧伤的临床治疗经验. 方法 46例54只深度烧伤手,其中深Ⅱ度烧伤30例33只手,Ⅲ度烧伤16例21只手.根据伤情不同,早期选择不同手术方式修复创面,术后早期进行功能锻炼. 结果 54只手的修复方式:中厚皮片移植33只手,异体脱细胞真皮与自体薄皮片复合移植12只手,腹部带蒂皮瓣1只手,前臂骨问背动脉逆行皮瓣3只手,股前外侧皮瓣5只手.治疗后,51只手移植皮片、皮瓣均成活,仅3只手移植皮片后有局灶性坏死,创面得到有效覆盖.按关节活动范围( range of motion,ROM)评定,本组优31只手(57.4％),良17只手(31.5％),中4只手(7.4％),差2只手(3.7％). 结论 手部深度烧伤后,选择合适术式,早期手术修复创面及功能锻炼,可取得很好的疗效.

Analysis of Clinical Treatment of Deep Burn of Hands

Objective To summarize the clinical experiences in the treatment of hand deep burns.Methods Different methods of wound reparation were used to 54 deep burned hands in 46 cases,according to the severity of traumatic condition.There were 30 cases with 33 hands of deep Degree Ⅱ and 16 cases with 21 hands of Degree Ⅲ.The wound repair approaches included split-thickness skin graft of 33 hands,combined skin transplantation of allogenic acellular dermis and autologous thin skin of 12 hands,abdominal pedicled skin flaps of 1 hand,dorsal interosseous artery forearm flap of 3 hands and anterolateral femoral skin flap of 5 hands.And early postoperative functional exercises were carried out in the guidance of the surgeon. Results After the treatment,the transplant skin flaps survived in 51 hands except 3 hands suffered from the focal skin necrosis.According to the range of motion(ROM) assessment,there were 31 hands(57.4%) excellent,17 hands(31.5%) good,4 hands(7.4%) fair and 2 hands(3.7%) worse.The overall restore of the 52 hands obtained the satisfactory effect both in the contour and the function.Conclusion It would achieve good results of the appropriate operation selection,early surgical repair of the wound and early functional exercises after deep burns of the hands.