儿童颌面部狗咬伤急诊美容缝合的临床效果观察

Clinical effect of emergency on maxillofacial dog bites in cosmetic suture

目的探讨儿童颌面部狗咬伤行急诊美容缝合的可行性及临床效果。方法对24例严重颌面部狗咬伤(无明显皮肤软组织缺损)患儿,受伤最长时间达14小时,进行急诊清创美容缝合术,术后1周拆线,拆线后抗疤痕治疗3-6个月,并进行临床观察、随访。随访6~12个月,平均随访8个月。结果临床观察、随访的24例病例中,23例患儿伤口一期愈合,无明显疤痕增生;1例患儿术后第5日,发生伤口感染,红肿明显处拆除缝合线2根,通过换药,伤口两周愈合,拆线处轻度疤痕形成;24例患儿均未发生狂犬病及破伤风杆菌感染。结论儿童颌面部狗咬伤,施行急诊美容缝合术,愈合时间短,明显提高颌面部狗咬伤患儿的生活质量。一期美容缝合的伤口比普通缝合及延期缝合更美观,适用于颌面部狗咬伤患儿。

Objective To discuss the feasibility and clinical efect of emergency operation of maxillofacial dog bite wound in children. Methods Bite in 24 cases of severe maxillofacial dog （no obvious skin and soft tissue defects） children, hurt the long time up to 14 hours, for a period of emergency debridement and suture operation, postoperative 1 week stitches, stitches after anti scar treatment for 3-6 months, and the clinical observation and follow-up. Followed up for 6 to 12 months with an average follow-up of 8 months. Result 24 cases of clinical observation and follow-up, 23 cases with wound healing, no obvious scar hyperplasia; ffth, 1 cases of postoperative wound infection, swelling, obvious removal of suture line 2, through two weeks of dressing, wound healing, stitches at mild scar formation; 24 cases were not. Rabies and tetanus infection. Conclusion Children with maxillofacial dog bites, emergency phase I suture, short healing time, and signifcantly improve the quality of life of children with facial bitten by dogs. The cosmetic suture is more beautiful than the conventional suture and delayed suture, and it is suitable for the dog bite in the maxillofacial region.