四肢大面积皮肤撕脱伤的处理

Surgical management of extensiie skin avulsed wound of limbs

【目的】探讨四肢大面积皮肤撕脱伤的外科处理方法。【方法】选择1998年4月-2006年3月60例四肢大面积皮肤撕脱伤患者,其中19例采取带蒂反取皮法修复,31例采取单纯反取皮法修复,10例采取单纯反取皮法联合游离皮瓣修复。【结果】带蒂反取皮法19例,皮片成活率达89.5%(17/19),单纯反取皮法31例,皮片成活率达83.9%(26/31),单纯反取皮法联合皮瓣修复10例,皮片成活率达80%(8/10)。【结论】对四肢大面积皮肤撕脱伤,根据损伤程度和被撕脱皮肤完整与否、血供良好与否、撕脱皮肤下软组织条件、是否合并骨骼、肌腱、神经外露,采取带蒂反取皮法、单纯反取皮法或单纯反取皮法联合皮瓣修复创面,可取得良好效果。

[Objective] To discuss the surgical management of extensive skin avulsed wound of limbs. [Methods] A total of 60 cases of extensive skin avulsed wound of limbs were chosen from 1998, 4 to 2006, 3. Among them 19 cases were treated with pedicle skin grafting, 31 cases with free skin grafting from injuried skin and 10 cases with free skin grafting from injuried skin and flap. [Results] Skin survival rate was 89.5 % （17/19）in pedicle skin grafting, 83.9% （26/31）in free skin grafting from injuried skin and 80% （8/10）in free skin grafting from injuried skin and flap. [Conclusion] The repair method of extensive skin avulsed wound of limbs should be chosen according to the status of wound, avulsed skin etc, by pedicle skin grafting, free skin grafting from injuried skin and free skin grafting from injuried skin and flap, the effect is good.