Department of Dermatology, Sunderland Royal Hospital, Sunderland, UK.
Clin Exp Dermatol. 2013 Aug;38(6):606-11. doi: 10.1111/ced.12044. Epub 2013 Jun 13.
The dorsum of the hand is a common site for squamous cell carcinoma, and excision with appropriate margins often results in surgical defects that cannot be repaired by primary side-to-side closure.
To assess healing time, complications and resulting scars when surgical wounds on the dorsum of the hand were allowed to heal by secondary intention.
This was a prospective study of 28 surgical defects on the dorsum of the hand, which were allowed to heal by secondary intention. Patients were followed up on days 2, 7 and 14, and then every 2 weeks until the wounds healed. Wound dressings were changed 2-3 times per week. Patients' tolerance of this treatment and their degree of satisfaction with the final results was determined.
The defect diameters ranged from 15 to 46 mm (median 24 mm). The time to heal was determined in 24 patients, and ranged from 22 to 63 days (median 44 days). There were no cases of postoperative bleeding. Two patients developed erythema of the wound edge; wound swabs for culture were negative in both cases. Overgranulation developed in 12 of 28 wounds, which settled with the application of a potent topical steroid and discontinuation of the hydrocolloid dressing. Patients were either 'very satisfied' (12/18) or 'satisfied' (6/18) with the resulting scar.
Secondary intention healing of surgical wounds on the dorsum of the hand is a useful management option, which is well tolerated by patients, has a low rate of complications, and gives good cosmetic results.
手背是鳞状细胞癌的常见部位，通过适当的边缘切除通常会导致手术缺陷，无法通过直接对合缝合来修复。
评估手背手术伤口采用二期愈合时的愈合时间、并发症和由此产生的疤痕。
这是一项对 28 例手背手术缺损采用二期愈合的前瞻性研究。患者在第 2、7 和 14 天以及之后每 2 周随访，直到伤口愈合。每周更换 2-3 次伤口敷料。评估患者对这种治疗的耐受性和对最终结果的满意度。
缺损直径为 15-46mm（中位数 24mm）。24 例患者的愈合时间从 22 天到 63 天不等（中位数 44 天）。无术后出血病例。2 例患者出现伤口边缘红斑，两者的伤口拭子培养均为阴性。28 例中有 12 例出现过度肉芽组织形成，通过使用强效局部类固醇和停止使用水胶体敷料后痊愈。18 例患者中，12 例（67%）对最终疤痕非常满意，6 例（33%）满意。
手背手术伤口采用二期愈合是一种有用的处理方法，患者耐受性良好，并发症发生率低，美容效果好。
