分期手术结合中药外敷治疗电烧伤头部皮肤缺损并颅骨外露效果分析.docVIP

分期手术结合中药外敷治疗电烧伤头部皮肤缺损并颅骨外露效果分析 　　[摘要]目的：总结分期手术结合中药外敷治疗电烧伤头部皮肤缺损颅骨外露的方法及临床疗效。方法：2008年12月-2013年12月，笔者对6例电烧伤头部皮肤缺损（面积4cm×7cm～6cm×12cm）并颅骨外露（面积3cm×4cm～5cm×10cm）患者，手术清创后涂抹自制的“当归逐瘀生肌膏”。若颅骨外板坏死，则行颅骨外板磨除或钻孔出血后继续中药外敷直至创面愈合。6个月后行皮肤软组织扩张术，之后予推进皮瓣修复缺损。结果：术后随访3～6个月，所有患者皮瓣完全成活，毛发生长良好。均未发生颅内感染、骨髓炎、大出血、皮瓣坏死等并发症。结论：分期手术结合中药外敷治疗电烧伤头部皮肤缺损颅骨外露，是一种安全有效、简单易行且创面修复及术后头部外观良好方法。 中国论文网 /6/view-7191493.htm 　　[关键词]头皮缺损；颅骨外露；电烧伤；皮肤软组织扩张术；皮瓣；中草药 　　[中图分类号]R622 [文献标志码]A [文章编号]1008-6455（2015）22-0005-04 　　Abstract： Objective To summarize the methods and therapy of staging operation combined with Chinese herbal for scalp defect with skull exposure after electric burn. Methods From December 2008 to December 2013，we treated 6 cases with scalp defect（4cm×7cm to 6cm×12cm）and skull exposure（3cm×4cm to 5cm×10cm）after electric burn by staging surgery，then smeared Chinese herbal， Danggui Zhuyu Shengjigao，on the surface of a wound.We would resect the skull plate or drill on the skull plate if the skull plate necrosis， and then continue to apply the Chinese herbal until the wounds healed.Skin soft tissue expansion was performed in 6 months after wounds healed.The skin expanders were took out and skin flaps were performed in 2 to 5 months after skin soft tissue expansion. Results Postoperative follow-up ranged from 3 to 6 months.The skin flaps survived completely and the hair in the repaired area grew well.There were no complications such as intracranial infection，osteomyelitis， massive haemorrhage，or skin flap necrosis. Conclusion It is a simple and practicable method that scalp defect with skull exposure after electric burn were treated with staging surgery combined with Chinese herbal.It is not only can repair wound but also can restore appearance of the head. 　　Key words：scalp defect；skull exposure；electric burn；skin soft tissue expansion；skin flap；Chinese herbal 　　电烧伤致头部皮肤缺损颅骨外露，临床较常见。目前临床对电烧伤致头部皮肤缺损颅骨外露的治疗方式主要包括颅骨外板磨除游离植皮术、钻骨引髓培养肉芽组织植皮术、大网膜移植游离植皮术、邻近皮瓣局部转移或游离皮瓣移植+植皮术等方法，均可获得较好疗效[1-5]。但这些方法均存在共同的缺点：不论是