Waikakul S
Department of Orthopaedic Surgery, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Injury. 1997 May;28(4):271-4. doi: 10.1016/s0020-1383(97)00011-9.
Between 1990 and 1994 a study was carried out of 32 patients who had degloving injuries of the limbs. There were three types of injuries: type I, nine patients with severely damaged skin and subcutaneous tissue; type II, 13 patients whose skin and subcutaneous tissue were moderately damaged, but subcutaneous veins were still identifiable; and type III, 10 patients whose skin and subcutaneous tissue were moderately damaged and venous back flow was observed. The patients in type I were treated by extensive debridement and the flaps were used for free full and split thickness skin grafting. In type II, arterialization of the venous system of the flaps was performed and successful perfusion was observed in nine patients. In type III, venous anastomoses were performed and all had good results. Revascularization of the flaps in types II and III degloving injuries of the limbs gave good results. The raw surface which needed skin grafting was minimized and the course of treatment and morbidity were decreased.
1990年至1994年间,对32例肢体脱套伤患者进行了一项研究。损伤分为三种类型:I型,9例患者皮肤和皮下组织严重受损;II型,13例患者皮肤和皮下组织中度受损,但皮下静脉仍可辨认;III型,10例患者皮肤和皮下组织中度受损且观察到静脉回流。I型患者采用广泛清创术,并用皮瓣进行游离全厚和中厚皮片移植。II型患者进行皮瓣静脉系统动脉化,9例患者观察到成功灌注。III型患者进行静脉吻合,所有患者效果良好。II型和III型肢体脱套伤皮瓣的血管重建效果良好。需要植皮的创面最小化,治疗过程和发病率降低。