McCann John, Miyamoto Sheridan, Boyle Cathy, Rogers Kristen
Children's and Adolescent's Research and Evaluation Center, University of California, Davis, California, USA.
Pediatrics. 2007 Nov;120(5):1000-11. doi: 10.1542/peds.2006-0230.
The objective of this study was to identify the healing process and outcome of nonhymenal injuries in prepubertal and pubertal girls.
This multicenter, retrospective project used photographs to document the healing process and outcome of nonhymenal genital injuries in 239 prepubertal and pubertal girls whose ages ranged from 4 months to 18 years.
The genital injuries sustained by the 113 prepubertal girls consisted of 21 accidental or noninflicted injuries, 73 injuries secondary to abuse, and 19 injuries of unknown cause. All 126 pubertal girls were sexual assault victims. These nonhymenal genital injuries healed at various rates depending on the type and severity. There was no statistical difference in the rate of healing between the 2 groups. Abrasions disappeared by the third day after injury. Edema was no longer present by the fifth day. Ecchymosis (bruising) resolved within 2 to 18 days depending on the severity. One prepubertal girl still had a labial hematoma at 2 weeks. Submucosal hemorrhages of the vestibule and fossa navicularis resolved between 2 days and 2 weeks. Petechiae and blood blisters proved useful for approximating the age of an injury. Petechiae were gone by 24 hours, whereas blood blisters were detected at 30 days in a prepubertal girl and 24 days in a pubertal girl. The depth of a laceration determined the time required for it to heal. Superficial vestibular lacerations seemed healed in 2 days, whereas deep perineal lacerations required up to 20 days. The appearance of new blood vessel formation was detected only in prepubertal girls, whereas scar tissue formation occurred only after a deep laceration in both groups.
The majority of these nonhymenal genital injuries healed with little or no evidence of previous trauma. The time required for resolution varied by type, location, and severity.
本研究的目的是确定青春期前和青春期女孩非处女膜性损伤的愈合过程和结果。
这个多中心回顾性项目使用照片记录了239名年龄在4个月至18岁之间的青春期前和青春期女孩非处女膜性生殖器损伤的愈合过程和结果。
113名青春期前女孩的生殖器损伤包括21例意外或非故意伤害、73例虐待所致损伤以及19例原因不明的损伤。所有126名青春期女孩均为性侵犯受害者。这些非处女膜性生殖器损伤根据类型和严重程度以不同速度愈合。两组之间的愈合速度没有统计学差异。擦伤在受伤后第三天消失。水肿在第五天不再存在。瘀斑（淤青）根据严重程度在2至18天内消退。一名青春期前女孩在2周时仍有阴唇血肿。前庭和舟状窝的黏膜下出血在2天至2周内消退。瘀点和血疱有助于推断损伤时间。瘀点在24小时内消失，而一名青春期前女孩在30天时检测到血疱，一名青春期女孩在24天时检测到血疱。撕裂伤的深度决定了其愈合所需时间。浅表前庭撕裂伤似乎在2天内愈合，而深部会阴撕裂伤则需要长达20天。仅在青春期前女孩中检测到新血管形成的迹象，而两组中只有深部撕裂伤后才会形成瘢痕组织。
这些非处女膜性生殖器损伤大多愈合，几乎没有或没有先前创伤的证据。消退所需时间因类型、位置和严重程度而异。
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