烧伤整形截肢术中的微创操作及引流

Use of minimally invasive operation and drainage during the amputation of burn and plastic surgery

目的 探讨烧伤整形截肢术的微创操作及肢体残端创腔安放引流管的必要性及益处。方法 在知名血管得到妥善处理的前提下 ,采取少缝扎或不缝扎肌肉断端、留置创腔引流管接负压引流的方法 ,并最大程度的减少组织损伤 ,做到微创操作。结果 5年共收治的 33例截肢病人中 ,2 1例采用常规手术方法 ,1 2例采用了改良手术方法。常规手术方法组术后有 3例合并皮瓣下血肿 ,4例发生感染流液 ,2例发生不同程度的皮瓣坏死 ,并发症发生率为 4 2 .9%;而改良手术方法组术后仅 1发生皮瓣下感染流液 ,并发症发生率为 9.1 %。结论 截肢术肢体残端创腔安放引流管保证了肢体残端的 期愈合 ,缩短了病员的住院时间 ,并能提高安装假肢的成功率 ,提高患者的生活质量。

Objective To discuss the necessities and benefits of performing minimally invasive operation and drainage tubes during the amputation of burn and plastic surgery Methods After the major vessels were appropriately managed, we took the measure of less even not suturing or ligating the muscle of the stump, and putting the drainage tube into the cavity of the stump for suction drainage, reducing the tissue injury by all means if possible. Results Among 33 patients undergoing amputation, 21 received routine amputation technique, the other 12 were treated with modified technique. In the routine treatment group, 3 patients complicated by sub skin-flap hematoma, 4 patients by infection, 2 patients by necrosis of the skin flap and the rate of complications accounted for 42.9%. While in the other group, only 1 patient complicated by infection, and the rate of complications accounted for 9.1%. Conclusion Minimally invasive operation and drainage will ensure the healing of the stump by first intention, shorten the time of hospitalization, and enhance the successful rate of artificial limb, and thus promote the patients' life quality.