摘要
目的观察全头皮撕脱伤急诊再植的远期疗效,总结其再植要点及临床意义。方法自1994年11月至2005年6月收治全头皮撕脱伤12例,采用直接或通过血管移植吻合单侧或双侧颞浅动静脉的显微外科治疗方法,实行全头皮原位再植处理。结果8例100%成活;2例90%成活;2例完全坏死,Ⅱ期中厚皮片游离植皮处理。结论正确及时的术前准备、耐心而熟练的术中操作及科学的术后处理是全头皮再植获得成功的保证;撕脱头皮的整体性是再植获得成功的前提;头发的再生主要与损伤程度、缺血时间有关,神经营养对其影响甚微。血供重建以颞浅血管为首选,确保单侧颞浅动静脉(1:2)通畅即可使头皮成活。该治疗方法疗效极佳,应积极再植,同时合理选择适应证,防止手术失败。
Objective To observe the remote efficacy of total scalp avulsion replantation and summarize its clinical significance and the main points of the replantation procedure. Methods A total of 12 cases with total scalp avulsion were admitted in our hospital from November 1994 to June 2005. All cases were treated with total scalp replantation in situ by microsurgery of anastomosing the superficial temporal artery & vein on side or both sides directly or with vasotransplatation. Results Of all, the total scalp survived in 8 cases, 90% survived in 2, and total necrosis in 2 who were treated with stage Ⅱ medium and thick flap plantation. Conclusions Right and prompt preoperative preparation, perfect and patient perioperative manipulation and scientific postoperative management are the guarantees for the success of scalp replantation and the integrity of scalp is the premise of the procedure. The hair regeneration mainly depends on the degree of scalp injury and the ischemic time, while the nutrition of nerves has little influence on it. The superficial temporal vessel is the first choice for re-establishment of blood supply. As the therapeutic effect is perfect, microvascular replantation should be done timely and the failure should be avoided by mastering the reasonable indication at the same time.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2007年第5期360-363,共4页
Chinese Journal of Trauma
关键词
头皮
头部损伤
再植术
显微外科手术
Scalp
Brain injuries
Replantation
Microsurgical operation