White W L, Hollsten D A
Brooke Army Medical Center, Fort Sam Houston, TX, USA.
Curr Opin Ophthalmol. 1994 Oct;5(5):74-7.
Ocular and periocular burns continue to be very complicated problems to manage clinically. Significant contributions have been made over the last year regarding the care and rehabilitation of the patient with this type of injury. N-acetylglucose aminidase activity in burned corneoscleral tissues may prove to be a good clinical indicator to assess the severity of ocular burns. Tenonplasty and split-thickness dermal grafts offer alternatives to conjunctival flaps when the latter is not practical or possible. Split-thickness dermal grafts are useful for treating persistent corneoscleral defects when an environment conducive to free grafts exists. Tenonplasty is a useful procedure in patients with persistent corneoscleral defects in whom no conjunctiva is available and a free graft is not advisable. Oversized soft contact lenses may prove useful in the care of the burn patient predisposed to forniceal foreshortening. An algorithm has been presented to aid in the management of the patient with periocular burns. High-density porous polyethylene can be successfully utilized in the reconstruction of the facial skeleton in burn patients. Useful guidelines have been proposed for the use of tissue expanders in the lower face and neck in pediatric burn patients.
眼部和眼周烧伤在临床上仍然是非常复杂的治疗难题。过去一年在这类损伤患者的护理和康复方面取得了重大进展。烧伤的角膜巩膜组织中的N-乙酰葡糖胺酶活性可能被证明是评估眼部烧伤严重程度的良好临床指标。当结膜瓣不可行或不可能时，Tenon囊成形术和中厚皮片移植为结膜瓣提供了替代方案。当存在有利于游离移植的环境时，中厚皮片移植可用于治疗持续性角膜巩膜缺损。对于没有结膜且不适合游离移植的持续性角膜巩膜缺损患者，Tenon囊成形术是一种有用的手术。超大号软性隐形眼镜可能被证明对易发生穹窿部缩短的烧伤患者的护理有用。已经提出了一种算法来辅助眼周烧伤患者的管理。高密度多孔聚乙烯可成功用于烧伤患者面部骨骼的重建。已经为小儿烧伤患者在下颌和颈部使用组织扩张器提出了有用的指导原则。
