不完全皮肤撕脱伤后皮肤活力判断与治疗

　　【英文篇名】DETERMINATION OF THE CUTANEOUS VIABILITY OF SKIN FOLLOWING INCOMPLETE AVULSION AND ITS TREATMENT

　　【作者中文名】马勇光; 李健宁; 李比; 夏有辰; 尤维涛; 王侠; 牛星焘;

　　【作者英文名】Ma Yongguang; Li Jiaoning; Li Bi; et al. Department of Plastic Surgery; Third Affiliated Hospital; Beijing Medical University. Beijing; P.R.China 100083;

　　【作者单位】北京医科大学第三医院成形外科;

　　【文献出处】中国修复重建外科杂志, CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY, 编辑部邮箱 1999年 01期

　　期刊荣誉：

　　【关键词】皮肤撕脱伤; 皮肤活力; 皮肤血供;

　　【英文关键词】Avulsion injury Viability Blood supply;

　　【摘要】目的观察主观指标判断不完全皮肤撕脱伤皮肤血运的可靠性。方法总结27例不同部位的不完全撕脱皮肤，利用皮肤颜色、皮肤温度、指压回血反应及针刺出血等主观指标判断撕脱皮肤的血循环。结果主观指标存在较高的失误率，其中5例完全成活，7例皮肤边缘或小面积坏死，其余15例均出现较大面积的坏死。将2例肢体大面积脱套伤患者的撕脱皮肤作成带真皮下血管网的皮瓣，并试行皮肤轴向多切口切开的方法治疗，使大部分撕脱皮肤得以成活，最大限度地保存和利用了组织。结论对血循环指标良好，但有挤压和碾挫痕迹的撕脱皮肤，或血循环指标不确切、不稳定的撕脱皮肤，清创时应积极予以去除，以提高手术的成功率。

　　【英文摘要】Objective In the determination of the viability of skin following incomplete avulsion, subjective criteria such as color, skin temperature, pressure reaction and the stab bleeding would often give a high rate of failure. In order to resolve this problem, a retrospective study was carried out. Methods In 27 patients, there were 18 males and 9 females, the age ranged from 7 to 41 years old. In operation, the blood supply of the skin was determined by above subjective criteria carefully. Results After op…