Dominic W, Hansbrough J F, Field T O, Carroll W B
Department of Surgery, University of California, San Diego Medical Center.
Burns Incl Therm Inj. 1988 Apr;14(2):139-41. doi: 10.1016/0305-4179(88)90220-3.
We describe a severe case of warfarin-induced skin necrosis with extensive full-thickness tissue loss involving approximately 12 per cent of the body surface area. The early management was conservative, with wound observation only, and no aggressive débridement was attempted. Wound and associated systemic sepsis followed, and the patient was transferred to our burn unit. The wounds were then managed with aggressive therapy including surgical excision, temporary coverage with allograft, and final closure with split-thickness autograft. This case illustrates important principles of appropriate surgical management of extensive skin lesions of this type.
我们描述了一例华法林所致皮肤坏死的严重病例，患者出现大面积全层组织缺损，累及体表面积约12%。早期处理较为保守，仅对伤口进行观察，未尝试积极清创。随后伤口及相关全身性感染发生，患者被转至我们的烧伤科。之后对伤口采取了积极治疗，包括手术切除、用同种异体皮临时覆盖以及用分层自体皮最终闭合伤口。该病例阐明了这类大面积皮肤损伤恰当手术处理的重要原则。
