26例四肢电击伤深度创面修复体会

Experience on 26 Cases with the Repair of Deep Wound of Electric Injury in Limbs

目的:探讨四肢深度电击伤创面不同时期处理的最佳手术方式。方法:笔者通过对近10年26例31个肢体四肢电击伤深度创面根据不同时期灵活采用岛状皮瓣、轴型带蒂皮瓣、游离皮瓣、随意皮瓣、皮片移植等不同手术方式修复,比较手术方式及观察治疗效果。结果:26例31个肢体四肢电击伤深度创面接受治疗,除2例游离皮瓣生长欠佳需二期手术及错过早期治疗单纯行肉芽创面植皮术后功能恢复较差外,其余效果满意。结论:电击伤后应争取早期清创,一期封闭创面,首选轴型皮瓣(岛状或带蒂),次选随意皮瓣,对于不能利用以上二种方法修复,才慎重考虑选用游离皮瓣,对于错过早期修复或者相对较浅的创面可考虑皮片移植。

Objective： To explore the best operative ways on the treatment of different period in deep wound of electric injury in limbs. Method： 26 cases and 31 limbs＇ deep wounds of electric injuries were flexibly adopted the repairs in differently operative ways according to different periods in nearly 10 years, such as island skin flap,pedicled skin flap of axes,free skin flap,random skin flap and skin transplanting, the author compared operative ways and observed treatment effects. Result： 26 cases and 31 limbs＇ deep wounds of electric injuries were cured, the effects were satisfactory, except that 2 cases＇ free skin flap growths grafting were ineffective, who needed Ⅱ stage operation and they missed early treatment and after simply skin in granulation, the functions restored worse. Conclusion： After electric injury, early debridement should be strived for, Ⅰ stage closed wound surface, pedicled skin flap of axes （ island or pedicle ） should be firstly chosen, the second was random skin flap, the free skin flap was only cautiously considered because above 2 repairs could not be used, missing early repair or relatively washy wound surface could consider skin grafting.