反取皮植皮术治疗肢体撕脱伤疗效探讨

Discussion about the Cure Effect of Using Debridement and Skin-grafting to Treat Limb Avulsion Injury after Cutting Skin Flap in Situ

目的探讨治疗肢体撕脱伤的最佳方法。方法对2010年-2013年收治的28例肢体撕脱伤患者均采取反取皮植皮术治疗,即将撕脱皮肤原位缝合后,用取皮机原位收中厚皮片,并于清创后一期游离移植于撕脱伤创面,术后应用湿润烧伤膏加压包扎治疗,观察皮瓣成活情况及创面修复效果。结果28例患者创面均一次性修复,其中22例患者的皮片成活率为100%,6例患者的皮片成活率为85%。随访1年,除4例患者失访外,其余24例患者的患肢外形与功能均恢复良好。结论应用反取皮植皮术修复肢体撕脱伤创面操作简便易行,且创伤小、愈合快,肢体外形和功能恢复满意。

Objective Discuss the best treatment for limb avulsion injury. Method 28 patients with limb avul-sion injury admitted from 2010 to 2013 were given debridement after skin flaps were cut in situ. Then, they received the au-tologous free skin flap grafting operation to repair the wound. After the avulsed skin was sutured in situ, split-thickness skin flap was taken in situ and grafted on the wound site after debridement, followed by MEBO ointment bandage treatment. The survival rate of grafted flaps and the effect of wound repair were observed. Result After the wounds of 28 patients were re-paired, skin flap survival rate of 22 cases was 100%, 6 cases were 85%. In one year follow up, 4 cases were lost of con-tact, all the residual 24 cases recovered well in limbs’ appearance and function. Conclusion Using the debridement and skin-grafting to treat limb avulsion injury after cutting skin flap in situ could make wounds smaller and shorten the healing time, featuring easy operation. It is a satisfactory therapy to recover appearance and function of limbs.