腋窝瘢痕挛缩畸形植皮术后包扎方法的改进

Improving the method of bandaging for repairing armpit deformities with scar contracture by skin grafting

目的:改进传统的腋窝瘢痕挛缩畸形植皮术后包扎技术。方法:分析腋窝形态结构的特殊性而对基于普通弹性绷带的传统"8"字包扎技术进行2方面改进:①加一段弹性绷带在腋下水平缠绕胸、背部一圈,而使腋窝内侧壁包扎到;②在肩峰、上臂上端外侧、腋窝前、下、后侧用7号丝线将绷带相邻边缘缝扎固定一起,形成全腋窝弹性加压包扎法,并将此法用于13例(16侧)腋窝因广泛瘢痕增生并挛缩或粘连畸形而进行全厚皮片移植的患者。结果:手术切口均一期愈合,无血肿及皮片坏死发生,畸形改善明星,每次包扎后可维持7天不松散。全腋窝弹性加压包扎法使对术区包扎达到全方位、长久牢靠。结论:基于对腋窝结构特殊性而新创的全腋窝弹性加压包扎法牢固可靠,其用于腋窝植皮包扎预防皮片坏死效果确切有效。

Objective To improve the method of bandaging for repairing armpit deformities with scar contracture by skin grafting. Methods Based on analysing the particularity of axillary morphology structure, two aspects were improved for traditional ＂8＂ elastic bandaging. Firstly, by adding a length of elastic bandage to twine chest and back one circle,the medial walls of the armpits were bandaged. Secondly, at acromion,the upper end of lateral upper arm, the anterior, underside,posterior of theacromion,7# silk thread was used to suture ligate the adjacent edge of bandage to form the technique of elastic pressure bandaging the whole armpits. 13 cases （16 sides） of repairing armpit deformities with scar contracture by skin grafting and elastic pressure bandaging. Results All the operation incisions healed up at I stage. There wasn＇t hematoma and necrosis of grafted skin. The armpit deformities were improved obviously. All the bandagings didn＇t loose 7 days after operation. The elastic pressure bandaging provided omnibearing,exactly effective, long firm pressure to the whole armpits. Conclusion The new elastic pressure bandaging for the whole armpits prevented the necrosis of grafted skin exactly by causing the bandaging long firm and sturdy.