前臂和手部严重挤压伤：显微外科手术的作用

Severe Crush Injury to the Forearm and Hand: The Role of Microsurgery.

作者信息

Del Piñal Francisco, Urrutia Esteban, Klich Maciej

机构信息

Instituto de Cirugía Plástica y de la Mano, Private Practice, Hospital La Luz and Hospital Mutua Montañesa, Madrid/Santander, Spain.

Instituto de Cirugía Plástica y de la Mano, Private Practice, Hospital La Luz and Hospital Mutua Montañesa, Madrid/Santander, Spain; Department of Orthopaedic Surgery, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, Chile.

出版信息

Clin Plast Surg. 2017 Apr;44(2):233-255. doi: 10.1016/j.cps.2016.11.002. Epub 2017 Feb 1.

DOI:10.1016/j.cps.2016.11.002

PMID:28340660

Abstract

The main goals of treating severe crush injuries are debriding away devitalized tissue and filling any resultant dead space with vascularized tissue. In the authors' experience, the most ideal methods for soft tissue coverage in treating crush injuries are the iliac flap, the adipofascial lateral arm flap, and the gracilis flap. Accompanying bone defects respond very well to free corticoperiosteal flaps. Digital defects often require the use of complete or subtotal toe transfer to avoid amputation and restore function to the hand.

摘要

治疗严重挤压伤的主要目标是清除失活组织，并用带血管组织填充任何由此产生的死腔。根据作者的经验，治疗挤压伤时软组织覆盖的最理想方法是髂骨皮瓣、上臂外侧脂肪筋膜瓣和股薄肌瓣。伴有骨缺损时，游离皮质骨膜瓣的效果非常好。手指缺损通常需要进行全趾或部分趾移植，以避免截肢并恢复手部功能。