Reuter G
Z Kinderchir Grenzgeb. 1980 Jul;30 Suppl:135-9.
The hand was involved in 18.5% of our cases of heat injuries to children. First and second degree damage caused no diagnostic or therapeutic problems. Difficulties arose in distinguishing 3 a from 3 b injuries. With few exceptions, the clinical course justified a primarily conservative management. Heart injuries clearly of 3rd degree could only be primarily excised within certain limits, in the presence of shock, involvement of other regions and inadequate primary care. 12% of the thermically injured hands were admitted beyond the time-limit for primary delayed operation, and even for secondary transplantation. In five children, amputation was necessary after circular burns of 3rd degree by means of flames or electric current.
手部损伤占我们所治疗儿童热烧伤病例的18.5%。一度和二度损伤在诊断和治疗上均未出现问题。区分三度a型和三度b型损伤存在困难。除少数例外情况外，临床病程表明主要采取保守治疗是合理的。明确为三度的手部损伤，只有在存在休克、其他部位受累及初期处理不充分的情况下，才能在一定限度内进行一期切除。12%的热烧伤手部在超过一期延迟手术的时限后才入院，甚至错过了二期移植的时机。在5名儿童中，因火焰或电流造成的三度环形烧伤后不得不进行截肢。
