Barton D J, Sloan G M, Nichter L S, Reinisch J F
Division of Plastic Surgery, University of Southern California School of Medicine, Los Angeles, CA 90027.
Pediatrics. 1988 Dec;82(6):925-8.
We have witnessed six cases of the hair-thread tourniquet syndrome, an entity characterized by strangulation of an appendage (toes, fingers, or external genitalia) by hair or hair-like fibers in the pediatric population. All six of our cases were in infants, 12 days to 5 months of age. The offending fibers were hair in three of the four patients with toe injuries and synthetic fibers from mittens in the finger cases. All six patients were treated by immediate removal of the constricting fibers, and, in spite of the worrisome appearance of the tissue distal to the constriction, all six eventually healed without significant tissue loss. A review of the literature indicated 60 similar cases of this type reported, 24 involving toes, 14 involving fingers, and 22 involving genitals. The majority of the toe and external genitalia cases were caused by hair, whereas the majority of finger strangulations were caused by thread from mittens. At greatest risk for strangulation are the middle finger and third toe, followed by the index finger and second toe. Patients with finger or penile involvement were more likely to suffer significant complications from the injuries than those patients with toe involvement. Based on our own experience and that described in the literature, we recommend prompt removal of the offending fiber, followed by prolonged conservative management of the damaged distal tissue, in the hope of maximal tissue salvage. Increased physician awareness of this syndrome is mandatory for prevention, diagnosis, and early treatment.
我们目睹了6例毛发丝束带综合征，该病症的特征是在儿科人群中，毛发或毛发样纤维勒住肢体（脚趾、手指或外生殖器）。我们所有6例病例均为12天至5个月大的婴儿。在4例脚趾受伤患者中，有3例的致伤纤维是毛发，而手指病例中的致伤纤维是来自连指手套的合成纤维。所有6例患者均通过立即去除束紧纤维进行治疗，尽管束带远端组织外观令人担忧，但所有6例最终均愈合，无明显组织缺失。文献回顾显示，已报道60例类似病例，其中24例累及脚趾，14例累及手指，22例累及生殖器。大多数脚趾和外生殖器病例由毛发引起，而大多数手指勒伤由连指手套的线绳引起。最易被勒伤的是中指和第三趾，其次是食指和第二趾。与脚趾受累的患者相比，手指或阴茎受累的患者更易因损伤而出现严重并发症。根据我们自己的经验以及文献中的描述，我们建议迅速去除致伤纤维，随后对受损的远端组织进行长期保守处理，以期最大程度地挽救组织。提高医生对该综合征的认识对于预防、诊断和早期治疗至关重要。
