头皮撕脱伤治疗方法的回顾与探讨

Review on management of scalp avulsion injury

目的 回顾复习头皮撕脱伤的临床资料 ,总结治疗经验与体会。方法 对 195 8年至 2 0 0 0年 6月收治的72例头皮撕脱伤患者的临床资料进行了总结和分析 ,重点回顾了所采用的治疗方法。结果 受伤者多为年轻女性 ,主要由于头发绞入转动的机器所致。在选择治疗方法时 ,有条件再植的 ,应吻合血管再植 ,不能再植而骨膜完整者植皮为首选方法 ,颅骨外露者的首选方法是凿除颅骨外板直接植皮 ,也可以采用游离肌瓣移植加植皮的方法覆盖创面。游离大网膜移植和钻骨引髓、生长肉芽后再植皮的方法有其缺点。结论 头皮撕脱伤创面处理应该根据患者的伤情特点来确定 ,颅骨外露的处理有多种方法 ,各有优缺点。

Objective To review clinical data of scalp avulsion injury, and to summarize experiences in the management of the injury. Methods This article deals with 72 scalp avulsions treated by the authors in the last 40 years. Results The victims were predominantly young females and mainly owing to their hair caught up in moving machine. Various modalities of treatment are discussed. If it is possible to replant, one should try to anastomose the vessels. With intact periosteam, split-skin grafting remains the treatment of choice. In the presence of bare bone local flap is preferred when feasible, otherwise chiseling outer table of the skull with immediately spilt-skin grafting is first choice. Omentum transplantation and multiple drilling in outer table of skull to accelerate the formation of granulation tissue, followed by split-skin grafting can be used, but they bear disadvantages. Conclusion There are several techniques one can use to manage scalp avulsion injury.