手部热压伤处理体会

Treat experience of thermo-compression injury in hand

目的 探讨手部热压伤在临床的处理方法及效果.方法 对收治的16例手、腕部热压伤患者早期行切开引流,采用负压封闭引流技术（Vacuum Sealing Drainage,VSD）覆盖创面或无菌纱布包扎,Ⅱ期根据创面损伤程度行皮瓣移植或游离植皮术覆盖创面.结果 术后16例均成活,其中3例皮瓣远端出现坏死现象,后经植皮伤口愈合好转,1例因手术时机过早导致植皮坏死,Ⅱ期植皮术后恢复良好.术后皮瓣或植皮外观良好,皮肤感觉恢复至S2级,手部功能根据TAM系统评定法评定：优8例,良6例,可2例,优良率87.5％.结论 手部热压伤经过恰当的手术方法选择,并配合功能锻炼能较好地恢复外观及功能.

Objective To investigate of hand thermo-compression injury. Methods 16 cases of hand and wrist hot crush injury were treated by early incision drainage （VSD cover drainage or sterile gauze bandage）. According to the second phase of wound injury degree flap or skin graft were used to cover the wound. Results After operation, 16 cases survived, of which 3 cases had distal flap necrosis, wound healed after skin grafting, 1 case early choice of operation because of had necrosis of skin graft but recovery well after secondary. Postoperative flap or skin graft had good appearance, skin discrimination was S2, hand function according to the TAM system evaluation： excellent in 8 cases, good in 6 cases, fair in 2 cases, the excellent and good rate was 87.5%. Conclusion Through the proper operation methods, and functional rehabilitation had thermo-compression injury skin grafting restore the good appearance and function.