荧光素染料辅助下的手部烧伤切线切除与植皮术：实现最佳的美容和功能效果
Fluorescein Dye-Assisted Tangential Excision and Skin Grafting in Hand Burns: Achieving Optimal Cosmetic and Functional Outcomes.
作者信息
Singh Dylan, Wong Justin H, Parsa Alan A, Parsa Fereydoun D
机构信息
Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.
Plastic Surgery Division, Department of Surgery, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii.
出版信息
Eplasty. 2025 Jul 17;25:e26. eCollection 2025.
BACKGROUND
Burned hands require special attention and prompt treatment because of their vital functional importance. With fluorescein dye, it is possible to visualize vascular dermal layers to assist with the removal of nonviable skin through tangential excision.
METHODS
Within 24 to 48 hours after a burn, 5 mg of fluorescein dye was injected intradermally and a Wood light was used to determine burn depth. Under anesthesia, an Air Brown (Zimmer Biomet) or castroviejo dermatome and a free-hand or Humby knife was used to excise the burned skin. Split-thickness layers approximately 0.015 inches thick were removed until strong fluorescence was noted.
RESULTS
Observation indicators were used to assess the quality of the skin graft outcomes. No cases of infection, seromas, hematomas, or contractures were seen. Additionally, patients experienced reasonable cosmetic and functional outcomes within weeks to months following grafting.
CONCLUSIONS
Excision and split-thickness skin grafting with fluorescein dye and tangential excision can achieve desirable results and restore both cosmetic and functional outcomes.
背景
由于手部具有至关重要的功能，烧伤的手部需要特别关注并及时治疗。使用荧光素染料，可以观察到真皮血管层，以协助通过削痂术去除无活力的皮肤。
方法
在烧伤后24至48小时内，将5毫克荧光素染料皮内注射，并用伍德灯确定烧伤深度。在麻醉下，使用Air Brown（捷迈邦美）或卡斯特罗维霍皮肤刀以及徒手或汉比刀切除烧伤皮肤。去除约0.015英寸厚的断层皮片，直至观察到强烈荧光。
结果
使用观察指标评估植皮效果质量。未出现感染、血清肿、血肿或挛缩病例。此外，患者在植皮后数周数月内获得了合理的美容和功能效果。
结论
使用荧光素染料进行削痂术及断层皮片移植可取得理想效果，恢复美容和功能。
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