Turker Tolga, Capdarest-Arest Nicole
Division of Reconstructive and Plastic Surgery, University of Arizona Health Sciences Center, Tucson, AZ 85724, USA.
J Hand Surg Am. 2013 Aug;38(8):1641-50. doi: 10.1016/j.jhsa.2013.02.011. Epub 2013 Apr 3.
Hand trauma resulting from firearms is becoming more common in civilian life. In the past, as in wartime, infection was a main source of concern following firearm-related hand injuries, whereas in current civilian life with modern medical care, infection rates are actually low for such injuries. As infection is now of lesser concern, the focus should shift to improve functional outcomes. This review summarizes available literature regarding the management of gunshot wounds to the hand, with particular focus on functional outcomes. In conducting this review, we found that there is not comprehensive information regarding management of gunshot wounds to the hand, and literature discussing functional recovery of the hand is limited. Given the current evidence related to management of gunshot wounds to the hand, we believe that early debridement, antibiotic treatment, reconstruction, and rehabilitation offer patients the best chance for full functional recovery.
枪支导致的手部创伤在平民生活中越来越常见。过去,如同在战时一样,与枪支相关的手部损伤后,感染是主要的关注点,而在现代医疗条件下的当前平民生活中,此类损伤的感染率实际上很低。由于现在感染问题已不那么令人担忧,重点应转向改善功能结局。本综述总结了有关手部枪伤处理的现有文献,特别关注功能结局。在进行本综述时,我们发现关于手部枪伤处理的信息并不全面,且讨论手部功能恢复的文献有限。鉴于目前与手部枪伤处理相关的证据,我们认为早期清创、抗生素治疗、重建和康复为患者提供了实现完全功能恢复的最佳机会。