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[1]楊俊興,陳建發(fā),張華,等.形克氏針皮膚減張術(shù)治療四肢軟組織缺損[J].中醫(yī)正骨,2016,28(04):42-43,46.
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形克氏針皮膚減張術(shù)治療四肢軟組織缺損()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期數(shù):
2016年04期
頁(yè)碼:
42-43,46
欄目:
臨床報(bào)道
出版日期:
2016-04-20

文章信息/Info

作者:
楊俊興陳建發(fā)張華劉付懿斐王海彬方斌
廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院,廣東 廣州 510405
關(guān)鍵詞:
軟組織損傷 皮膚減張術(shù) 克氏針
摘要:
目的:探討自制“”形克氏針皮膚減張術(shù)治療四肢軟組織缺損的臨床療效和安全性。方法:2011年7月至2015年11月收治12例四肢軟組織缺損患者,男10例、女2例; 年齡19~66歲,中位數(shù)41歲; 腫塊切除術(shù)后3例、膝關(guān)節(jié)置換術(shù)后2例、截肢術(shù)后2例、跟腱斷裂縫合術(shù)后2例、左脛骨慢性骨髓炎竇道形成1例、左脛腓骨內(nèi)固定取出術(shù)后1例、右脛骨截骨術(shù)后1例; 軟組織缺損面積3 cm×3 cm至10 cm×5 cm; 病程2~13個(gè)月,中位數(shù)6個(gè)月。對(duì)創(chuàng)口進(jìn)行清創(chuàng)后,用直徑1.5 mm克氏針在距一側(cè)創(chuàng)面皮緣2~3 cm處從皮膚垂直穿入直至深筋膜,控制其在深筋膜下走行,穿入對(duì)側(cè)軟組織,在距對(duì)側(cè)創(chuàng)面皮緣2~3 cm處穿出。將克氏針兩端向心性牽引折彎,以創(chuàng)口雙側(cè)軟組織能夠?qū)崿F(xiàn)無(wú)張力狀態(tài)下聚合為度,然后將針尾及針尖分別折彎成“”形。根據(jù)創(chuàng)面大小確定克氏針數(shù)量,克氏針間距2 cm,將創(chuàng)口無(wú)張力下閉合后,根據(jù)創(chuàng)口張力和損傷程度選擇一期閉合或逐漸牽張直至創(chuàng)面閉合或可直接縫合為止。結(jié)果:12例患者的創(chuàng)口均于術(shù)中實(shí)現(xiàn)無(wú)張力下閉合。所有患者均獲隨訪,隨訪時(shí)間4~48個(gè)月,中位數(shù)36個(gè)月。術(shù)后創(chuàng)口均愈合,愈合時(shí)間12~21 d,中位數(shù)15 d。未發(fā)生感染、皮緣壞死、血腫形成及克氏針切割皮緣等并發(fā)癥。末次隨訪時(shí)創(chuàng)口皮膚外觀與感覺(jué)功能恢復(fù)良好,瘢痕較小。結(jié)論:應(yīng)用“”形克氏針皮膚減張術(shù)治療四肢軟組織缺損,操作簡(jiǎn)單,可在術(shù)中實(shí)現(xiàn)無(wú)張力下閉合創(chuàng)口,創(chuàng)口愈合快,并發(fā)癥少,可作為臨床治療四肢軟組織缺損的一種治療方案。

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備注/Memo

備注/Memo:
通訊作者:楊俊興 E-mail:[email protected]
更新日期/Last Update: 2016-08-30