手部深层组织严重感染的治疗

Treatment of hand deep tissue severe infection

目的 探讨手部深层组织严重感染的治疗方法。方法 对 3 78例手部深层组织严重感染患者 ,术前创面严格抗感染治疗 ,术中创面彻底清创 ,在清洁创面上覆盖血运丰富的游离肌皮瓣。术后创面用敏感抗生素溶液冲洗治疗。结果 3 78块肌皮瓣中 ,3 3 7块全部存活 ,一次手术治愈率为 89.1% ;另41例皮瓣远端部分坏死 ,第 2次清创后用局部皮瓣修复。结论 手部深层组织严重感染者 ,在彻底清创的基础上用吻合血管的肌皮瓣移植 。

Objective To investigate the treatment methods of severe hand deep tissue infection. Methods Severe hand deep tissue infections were treated in 378 cases.The appropriate anti inflammatory therapy was done before operation.Free vascularized musculocutaneous flap was used for wound coverage after radical debridement.Then the wound was irrigated with sensitive antibiotic solution after operation. Results Three hundred and thirty seven of 378 musculocutaneous flaps survived completely,with primary healing rate of 89.1%. Another 41 cases were treated with secondary debridement and local flap coverage after partial necrosis. Conclusion For patients with severe hand deep tissue infection, free musculocutaneous flap transplantation was an efficient method on a complete debridement basis.