28例手部喷漆枪击伤治疗分析

Treatment analysis of 28 cases of spray gun wounds in hands

目的：探讨手部喷漆枪击伤清创何时进行疗效最佳。方法将喷漆枪击伤后按清创时间不同分两组，常规组6～8 h内急诊清创；实验组先急诊切开减压、引流，12 h后待油漆干燥后再行二期清创。结果从2012年8月至2015年8月期间共收治喷漆枪击伤患者28例，常规组11例，术后7～12 h复查优良率45％；实验组17例，术后7～12 h复查优良率94％。结论对于喷漆枪击伤后不管是否有血管、神经损伤均实行急诊切开引流、减压，12 h后待油漆干燥再行二期清创，可提高油漆的清除率，减少反复清创的次数，减少皮肤软组织坏死率，后期的功能恢复优良率明显提高。

Objective To discuss the appropriate time of wound debridement due to spray gun .Methods The patients were divided into two groups according to the time of debridement .In the routine group , emergency debridement was implemented within 6~8 hours; In the experimental group , decompression and drainage emergency was implemented first , and then to be debrided after drying in 12 hours.Results A total of 28 patients of spray gun were treated from August 2012 to August 2015, the routine group was 11 cases, the excellent rate of review was 45%, the experimental group was 17cases, the excellent rate of review in 7~12 hours after operation was 94%.Conclusions For the wounds due to spray gun , regardless of blood vessels or nerve injury , we should implement emergency incision and drainage and decompression , the further debridement should be performed in 12 hours if the paint is dry , which can improve the paint clearance rate , reduce repeated debridement and the rate of the skin and soft tissue necrosis , the excellent rate of functional recovery is significantly improved .