Groenevelt F, Kreis R W
Neth J Surg. 1985 Dec;37(6):167-73.
Estimating the depth of burns of the hand remains difficult and requires considerable experience. One reason for this is that the depth of the burn can change in the first three days as a result of vascular spasm and thrombotic processes in the microcirculation of the skin. Extensive burns over the rest of the body and edema development also influence skin perfusion. The pathophysiological changes of thermal injury of the hand are discussed together with the interaction between infection reaction, edema development and mobility. The guidelines for primary treatment of burns of the hand are discussed. In essence the therapy consists of closing the skin as soon as possible, to eliminate the edema and to prevent infection. Recently a clear controversy has developed between conservative treatment or surgery of deep second degree burns and deep mixed burns of the hand. The advantages and disadvantages of these two therapies are discussed.
估算手部烧伤深度仍然困难，且需要相当丰富的经验。原因之一在于，由于皮肤微循环中的血管痉挛和血栓形成过程，烧伤深度在头三天可能会发生变化。身体其他部位的大面积烧伤以及水肿的形成也会影响皮肤灌注。本文讨论了手部热损伤的病理生理变化，以及感染反应、水肿形成和活动能力之间的相互作用。还讨论了手部烧伤的初期治疗指南。本质上，治疗包括尽快闭合皮肤，以消除水肿并预防感染。最近，对于手部深二度烧伤和深度混合烧伤的保守治疗或手术治疗之间出现了明显的争议。本文讨论了这两种治疗方法的优缺点。
