口腔颌面部熊抓伤一期缝合1例

Primary Closure for Facial Injury Caused by Bear Scratch: A Case Report

目的:动物咬伤、抓伤是口腔颌面部最常见的外伤性疾病之一,但目前对口腔颌面部动物咬伤、抓伤的患者是否应进行一期缝合仍存在争议。本研究将报道1例口腔颌面部熊抓伤一期缝合病例的治疗效果。诊治经过:患者,男性,49岁,因面部被熊抓伤20小时来院就诊,12小时前已接种破伤风、狂犬病免疫球蛋白及狂犬疫苗,在四川大学华西口腔医院彻底清创后对其进行了一期严密缝合,随访并记录了患者术后伤口感染、瘢痕愈合等情况。结果:患者一期缝合后伤口愈合良好,未出现术后伤口感染,且瘢痕较小,面部美观性较高。结论:对于可彻底清创的口腔颌面部动物抓伤患者,一期缝合可在不增加伤口感染率的同时改善术后美观功能,进而降低创伤对患者造成的容貌、生理及心理上的创伤。

Objective:Animal bites and scratches are one of the most common traumatic injuries in the oral and maxillofacial regions.However,there is still controversy over whether primary closure should be performed on patients with animal bites and scratches in the oral and maxillofacial regions.To clarify the therapeutic effect of primary closure for facial animal scratches,this study will report one case of primary closure for bear scratches.Diagnosis and treatment:A 49-year-old male patient visited the hospital 20 hours after being scratched by a bear on the face.He had received tetanus,rabies immunoglobulin,and rabies vaccine 12 hours earlier.In this study the wound debridement and primary closure was performed immediately at the first visit.Wound infection and aesthetic recovery were recorded during the follow-up.Results:The results showed that the patient underwent primary closure had no postoperative wound infection and got satisfactory scar recovery.Conclusions:For patients with facial animal scratches that can be thoroughly debridement,primary closure can improve postoperative aesthetic function without increasing wound infection rate,thereby reducing the appearance,physiological,and psychological trauma caused by the trauma to the patient.