亚急诊修复手部软组织缺损

Subemergency repair of soft tissue defect in the hand

目的 探讨亚急诊修复手部软组织的可行性。方法 1990～ 1999年对 3 5 2例手部软组织缺损患者 ,急诊修复 115例、亚急诊修复 13 9例 ,二期修复 98例。修复方式视损伤部位及程度的不同采用植皮、带蒂皮瓣和游离皮瓣三种方法。对 3组的皮瓣 (植皮 )感染率和坏死率进行回顾性分析。结果 ( 1)感染率 :亚急诊组为 2 .9% ( 4 /13 9) ,和急诊组加二期组相比 ,差异无显著性意义 (γ2 =0 .0 9,P >0 .0 5 )。( 2 )坏死率 :亚急诊组为 3 .6% ( 5 /13 9) ,和急诊组加二期组相比 ,差异无显著性意义 (γ2 =0 .0 0 0 2 5 ,P >0 .0 5 )。结论 3组的感染率和坏死率均无明显差别。亚急诊手术期以急诊清创后 1～ 5d为妥 ,临床应用疗效可靠。

Objective To investigate the practicalbility of subemergency repair of soft tissue defect in the hand. Methods From 1990 to 1999, 352 patients with soft tissue defect in the hand were treated with primary repair in 115 cases, subemergency repair in 139 cases and secondary repair 98 cases. According to the location and extent of the injury, skin graft, pedicled flap and free flap were the options included. Retrospective analysis of the infection rate and necrosis rate in 3 groups was done. Results Infection rate and necrosis rate of the subemergency repair group was 2.9 % (4/139) and 3.6 % (5/139) respectively. No significant difference was found between this group and the primary and secondary repair group. Conclusions There was no difference of the infection rate and necrosis rate in the 3 groups. Subemergency repair that was done 1 5 days after acute debridement had reliable treatment outcome.