腹部带蒂皮瓣修复腕部电烧伤的治疗效果观察

Analysis of the treatment of abdominal pedicle flap repair of wrist electric burn

目的观察腕部电烧伤患者通过腹部带蒂皮瓣修复治疗效果。方法选取2013年8月-2015年8月收治的50例腕部电烧伤患者的临床资料进行回顾性分析,观察50例患者的创面处理方式和功能恢复程度以及截肢情况。结果 50例患者行手术治疗58例次,非手术治疗5例次,其中采取扩创以及游离植皮8处,Ⅰ期愈合4处(50.0%);邻近随意皮瓣以及轴型皮瓣转移修复8处,Ⅰ期愈合5处(62.5%);腹部随意皮瓣、轴型皮瓣以及随意+轴型皮瓣40处,Ⅰ期愈合32处(80.0%)。本组50例患者无死亡病例,治愈49例,剩余1例回到当地医院继续治疗。随访显示,患者腕部电烧伤部位外形和关节活动度以及肌力情况良好,功能完全或是基本恢复,治疗效果满意。结论为腕部电烧伤患者实施早期切开减压、扩创以及皮瓣修复术,能够保证创面修复效果,减少截肢率,应该在临床中大力推广使用。

Objective To analyze the research of wrist electric burn patients through the abdomen with pedicled skin flap for repairing of treatment method,in order to provide the basis for clinical practice. Methods A total of August 2013 to August 2015 of wrist electric burn patient data of 50 cases of the implementation of retrospective analysis and summary of wounds in 50 cases of patients with treatment and functional recovery of the relationship between the degree and amputation.Results 50 patients underwent surgical treatment of 58 cases,and non operative treatment in 5 cases. Eight debridement and skin graft,stage I healing 4( 50. 0%); eight adjacent random flap and axial pattern flap to repair,stage I healing 5( 62. 5%);forty abdominal random flap,axial pattern skin flap and free + axial pattern skin flap,stage I healing 32( 80. 0%). There were no deaths in 50 cases,49 cases were cured,one patient returned to the local hospital to continue treatment. Follow up showed that patients with wrist electric burn site shape and range of motion and strength good,fully functional or recovered,curative effect satisfaction. Conclusion Implementation early incision decompression,debridement and flap surgery for wrist electric burn,can guarantee the healing effect,reduce the amputation rate,it should be popularized in clinic.