摘要
目的探讨应用显微外科技术联合置管负压引流技术治疗四肢挤轧逆行撕脱伤的临床效果。方法2016年1月-2019年7月,对20例四肢挤轧逆行撕脱伤采用显微外科技术联合置管负压引流技术进行治疗。结果术后15例撕脱组织完全成活,5例撕脱皮肤近心端小部分坏死(其中3例Ⅱ期植皮愈合,2例结痂愈合)。随访3~12个月,患手外形好,血供充分,皮肤质地柔软。结论应用显微外科技术联合置管负压引流技术治疗四肢挤轧逆行撕脱伤,既能Ⅰ期固定骨折、缝合肌肉肌腱后应用显微外科技术吻接血管、神经,又能通过持续负压引流有效清除渗液,减少毒素再吸收;还可缩小创面,消灭死腔;同时还能改善局部血液循环,减轻或消除水肿,促进肉芽组织生长,加快创面愈合;提高撕脱组织的成活率,减少血管危象的发生;降低四肢挤轧逆行撕脱伤的坏死及伤残率,减少多次手术的痛苦;减轻患者经济负担。是治疗四肢挤轧逆行撕脱伤的好方法。
Objective To investigate the application of microsurgical technique combined with negative pressure drainage in the treatment of retrograde avulsion injury of extremities.Methods From January2016 to August 2019,20 cases of retrograde avulsion injury of extremities were treated with microsurgical technique combined with negative pressure drainage.Results Fifteen cases of avulsion tissue survived completely after operation,5 cases of proximal avulsion skin had partial necrosis(including 3 cases of secondary skin grafting healing,2 cases of scab healing).Follow-uped for 3~12 months,the shape of the affected hand was good,the blood supply was sufficient,and the skin texture was soft.Conclusion The microsurgical technique combined with negative pressure drainage technique can be used to treat the reverse avulsion injury of extremities,that is to say,the fracture can be fixed in one stage,and the muscle and tendon can be sutured and anastomosed by microsurgical technique.Blood vessels and nerves can effectively remove exudate and reduce toxin reabsorption through continuous negative pressure drainage,reduce wound size,eliminate dead cavity,improve local blood circulation,reduce or eliminate edema,promote granulation tissue growth and accelerate wound healing.It improves the survival rate of avulsion tissue and reduces the occurrence of vascular crisis.Reduce the necrosis and disability rate of limb extrusion retrograde avulsion injury,reduce the pain of multiple operations,and reduce the financial burden of patients.Microsurgical technique combined with catheterization and negative pressure drainage is a good method for the treatment of extrusion and retrograde avulsion of extremities.
作者
谢建华
孙巧云
柴香林
王生钰
张克录
刘海华
叶国泰
戴鹏祥
XIE Jianhua;Sun Qiaoyun;CHAI Xianglin(Department of Hand Surgery,Dongguan Hengli People's Hospital,Dongguan,Guangdong,523460,China)
出处
《实用手外科杂志》
2020年第1期38-40,77,共4页
Journal of Practical Hand Surgery
基金
东莞市社会科技发展(一般)项目(项目编号:2018507150381479)。
关键词
显微外科
负压引流
撕脱伤
四肢
Microsurgery
Negative pressure drainage
Avulsion injury
Extremities
