早期切痂一期腹部轴型转移皮瓣修复腕部深度电烧伤疗效观察

Therapeutic effect of early scab-cutting combined with axis-like abdomen skin flap implanting in patients with wrist deep electrical burns

目的：探讨早期切痂一期腹部轴型皮瓣修复腕部深度电烧伤创面的临床效果。方法回顾性分析70例试行腹部轴型皮瓣修复腕部电烧伤患者的临床资料，按照实际处理情况将其分为早期切痂移植组和延迟切痂组，各35例。观察两组恢复的效果，针对患者术后出现创面感染率、创面愈合时间、皮瓣成活率、创面愈合等级、截肢率进行比较。结果手术后，早期切痂组患者创面感染率11％、创面愈合时间（24．0±6.0）d、皮瓣成活率97％、创面愈合等级（甲级33例，乙级和丙级共2例）、截肢率3％，延迟切痂组患者创面感染率31％、创面愈合时间（35．0±7．4）d、皮瓣成活率83％、创面愈合等级（甲级10例，乙级和丙级共25例）、截肢率17％，两组数据相比，差异均有统计学意义（χ2＝4．151、t＝6．831、χ2＝3．968、χ2＝31．895、χ2＝3.968，均P＜0．05）。结论早期清创切痂利用腹部各轴型皮瓣修复腕部深度电烧伤，能够有效覆盖创面，减少瘢痕增生，促进手部功能恢复，保护手部功能，减少并发症，缩短创面愈合时间和住院时间。

Objective To observe therapeutic effects of early scab-cutting combined with axis-like abdo-men skin flap implanting in patients with wrist deep electrical burns.Methods Retrospective study was employed to analyze 70 patients received axis -like abdomen skin flap implanting for wrist deep electrical burns.All the cases were separated with early scab-cutting group（35 cases）and delayed scab-cutting group（35 cases）,according to types of skin flap implanting.The therapeutic effect for the two groups were evaluated with rate of infection,duration of healing,living rate of skin flap,grade of skin burning,and rate of amputate.Results In the early scab -cutting group,the rate of infection was 11%,the duration of healing was（24.0 ±6.0）days,the rate of amputate was 3%,the living rate of skin flap was 97.0%,the wound healing of class A was 94.3%.In the delayed scab-cutting group,the data were respectively 31%,（35.0 ±7.4）days,17.0%,31% and 28.6%.Compared with the data of the two groups,the difference had statistical significance（the chi-square value or T value were respectively 4.151,6.831,3. 968,31.895,3.968.All the P values was less than 0.05）.Conclusion Early scab-cutting combined with varied sorts of skin flap implanting shown great benefits for treatment of wounded and facilitate rehabilitation in function of wrist,which suggest decrease rate of complications and minimized hospitalized duration.