手部蝰蛇咬伤的处理
The management of pit viper envenomation of the hand.
作者信息
Bozkurt Mehmet, Kulahci Yalcin, Zor Fatih, Kapi Emin
机构信息
Department of Plastic and Reconstructive Surgery, Dicle University, 21280 Diyarbakir, Turkey.
出版信息
Hand (N Y). 2008 Dec;3(4):324-31. doi: 10.1007/s11552-008-9114-2. Epub 2008 May 28.
Snakebites are common among the rural population of developing countries. The severity of venomous snakebites depends on several factors, including the location of the bite, the amount of venom injected, and the effectiveness of the initial therapy. Snakebites frequently occur in the extremities with approximately two thirds of envenomations occurring in the upper extremities. In this study, we presented 12 cases of hand reconstruction after Vipera snakebites and discussed how to minimize functional loss and maximize hand rehabilitation. Twelve patients bitten by Vipera between 2001 and 2006 were included in this study. Groin flaps were performed in three cases, full-thickness grafts in two cases, thenar flaps in three cases, and cross finger flaps in three cases. With medical management, spontaneous healing occurred in one case. We prefer to use flaps on the volar site of the hand and, if the bone is not exposed, full-thickness grafts on the dorsal site of the hand. We also recommend starting rehabilitation of the hand early.
蛇咬伤在发展中国家农村人口中很常见。毒蛇咬伤的严重程度取决于几个因素，包括咬伤部位、注入的毒液量以及初始治疗的效果。蛇咬伤常发生在四肢，约三分之二的中毒情况发生在上肢。在本研究中，我们展示了12例蝰蛇咬伤后手重建的病例，并讨论了如何将功能损失降至最低以及如何最大限度地促进手部康复。本研究纳入了2001年至2006年间被蝰蛇咬伤的12例患者。3例行腹股沟皮瓣移植，2例行全厚皮片移植，3例行大鱼际皮瓣移植，3例行邻指皮瓣移植。经药物治疗，1例自行愈合。我们更倾向于在手的掌侧使用皮瓣，如果骨头未外露，则在手的背侧使用全厚皮片。我们还建议尽早开始手部康复治疗。
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