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躯干和四肢脱套伤:整形外科团队早期评估与延迟评估结果的比较

Degloving injuries of trunk and limbs: comparison of outcomes of early versus delayed assessment by the plastic surgery team.

作者信息

Mello Daniel Francisco, Assef José Cesar, Soldá Sílvia Cristine, Helene Américo

机构信息

Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, BR.

Serviço de Emergência, Departamento de Cirurgia, Faculdade de Ciências Médicas, Santa Casa de Misericórdia de São Paulo, SP, BR.

出版信息

Rev Col Bras Cir. 2015 Jun;42(3):143-8. doi: 10.1590/0100-69912015003003.

Abstract

OBJECTIVE

to analyze cases of degloving of the trunk and limbs, comparing outcomes of early versus delayed assessment by the plastic surgery team.

METHODS

we conducted a retrospective analysis of medical charts. Patients comprised two groups: Group I - early assessment, performed within 12 hours post trauma; and Group II - delayed assessment, performed more than 12 hours post trauma. We defined primary grafting as the use of skin from the traumatized skin flap. We excluded cases involving hands, feet or genitalia.

RESULTS

there were 47 patients treated with degloving injuries between 2002 and 2010. The mean body surface area affected was 8.2%. Lower limbs were the most frequently affected site (95.7%), whether alone or in association with lesions to other sites. Delayed assessment by the plastic surgery team occurred in 25 cases. Mean hospital stay was 36.1 days for Group I and 57.1 days for Group II (p=0.026). Regarding the number of surgical operations (skin grafts), Group I received a mean of 1.3, while Group II underwent 1.6 (p=0.034).

CONCLUSION

based on length of hospital stay and number of operations in trauma patients with degloving of the trunk and limbs, plastic surgery assessment should be carried out early.

摘要

目的

分析躯干和四肢脱套伤病例,比较整形外科团队早期评估与延迟评估的结果。

方法

我们对病历进行了回顾性分析。患者分为两组:第一组——早期评估,在创伤后12小时内进行;第二组——延迟评估,在创伤后超过12小时进行。我们将初次植皮定义为使用创伤皮瓣的皮肤。我们排除了涉及手、足或生殖器的病例。

结果

2002年至2010年间有47例患者接受了脱套伤治疗。受影响的平均体表面积为8.2%。下肢是最常受影响的部位(95.7%),无论是单独受影响还是与其他部位的损伤同时存在。整形外科团队进行延迟评估的有25例。第一组的平均住院天数为36.1天,第二组为57.1天(p = 0.026)。关于手术操作(植皮)的次数,第一组平均接受1.3次,而第二组进行了1.6次(p = 0.034)。

结论

基于躯干和四肢脱套伤创伤患者的住院时间和手术次数,整形外科评估应尽早进行。

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