应用烧伤整形外科技术治疗大面积皮肤撕脱伤

Comprehensive Application of Burn Plastic Surgery Technology in The Treatment of Large Area Skin Avulsion Injuries

探讨大面积皮肤撕脱伤的治疗方法。分析总结大面积皮肤撕脱伤及合并损伤17例，根据伤情综合应用清创撕脱皮肤缝合、带蒂真皮下血管网皮瓣回植、撕脱皮肤反取皮回植、组织瓣转移修复、游离皮片移植、头皮取皮术、异体／异种皮移植、创面持续负压吸引VSD等治疗方法，观察创面修复、肢体外观及功能恢复情况。结果17例患者经综合治疗后创面均愈合。功能部位均予全层皮片或皮瓣修复；19处创面有深部组织外露，予皮瓣或肌瓣修复；随访6个月～3年，所有肢体功能良好。根据皮肤软组织损伤情况而综合运用多种烧伤整形外科技术修复大面积撕脱伤可缩短疗程，并最大可能保留受伤区域的功能与外观，改善患者生活质量。

To investigate the treatment of large area skin avulsion injuries, we analyzed the treatment methods of large area of skin avulsion combined other injuries in 17 patients, they were treated with debridement and suturing, subdermal vascular network skin flap replantation, back grafting mesh flaps taken from avulsed skin, reconstruction, of tissue flaps, skin graSt, scalp and allogene]c or xenogeneic skin graft, the vacuum sealing drainage （VSD） technology and so on, the situation of wound repair and physical appearance, function recovery were observed. The wound of 17 patients were cured satisfactorily by comprehensive treatment. The functional parts were repaired by 1 full-thickness skin or flap, 19 wounds which deep tissue exposed were repaired by flap or muscle flap. Followed up for 6 months to 3 years, all have good function. Comprehensive application of burn plastic surgery technology in the treatment of large area skin avulsion injuries based on skin and soft tissue damage situation can shorten the course of treatment, and restore the function and appearance of the injured area, improve the quality of life in patients.