新生儿先天性皮肤缺损17例

Congenital Skin Defect of 17 Newborn Infants

目的探讨新生儿先天性皮肤缺损的临床救治和创面处理方法。方法17例先天性皮肤缺损患儿通过采用抗休克、补液治疗,创面暴露或包扎换药,皮瓣转移手术等单一或综合处理方式进行治疗,总结其恢复过程中休克的处理时机,抗休克效果,液体补充规律,液体输入过程和液体治疗结果,不同面积、部位、缺损创面处理方式和注意事项。结合文献及临床结果,对先天性皮肤缺损患儿手术处理的必要性进行探讨总结。结果本组17例新生儿均恢复良好,无在院死亡或严重并发症发生。头顶皮肤缺损患儿1例自动出院后失访。16例随访1a,7例无明显瘢痕,功能恢复良好,局部仅留轻度色素改变;4例有轻度的瘢痕组织,均无明显功能影响;3例出现瘢痕增生、挛缩,其中2例并小脚趾萎缩;枕部和前胸皮肤缺损的患儿除切口瘢痕外,创面愈合良好。结论早期诊断、合理、正确的治疗可使新生儿先天性皮肤缺损有良好的预后。

Objective To investigate the management for congenital skin defect of newborn infants. Methods Seventeen cases of congenital skin defect were managed by anti - shock, fluid infusion,wound exposure or bandaging and dressing changed, and skin transferred, which were performed in single or combined. The procedure of the time and outcome of anti - shock ; the principle, procure and result of fluid infusion, different management and nt were recovered to variable dimension and position, retrospect the result of the patients for variable admission time were summarized. The necessity of surgical intervene for all kinds of condition combined with literature and clinical experience was investigated. The importance of the early treatment and rational therapy to these baby was summarized. Results All of them were got favourable prognosis with no morbidity and severe complication, followed up for 12 months to observe the restoration process. Sixteen cases of them were healing except one of them was lost on following - up visit. Seven cases had good function with no obvious scarring besides pigment. Scar of 4 patients were moderate. Cicatricial contraction was in 3 cases. The rest of the them had no obvious scarring besides pigment. The fifth toe was atrophia in 2 cases of the scarring patient. In cision scarring was for occipital and breast skin defect. Conclusion It will be the favourable prognosis of the congenital skin defect for rational and timely management.