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小腿开放性骨折伤口处理

Hits: 2917 Download times: 1291 Received:December 01, 1997 Revised:May 10, 1998

作者	Author	单位	Unit	E-Mail
汤晓正	TANG Xiao zheng	江西省人民医院,江西南昌330006	Jiangxi Provincial Peoples Hospital Jiangxi Nanchang 330006
李重学	LI Chong xue	江西省人民医院,江西南昌330006	Jiangxi Provincial Peoples Hospital Jiangxi Nanchang 330006

期刊信息：《中国骨伤》2000年13卷，第1期，第16-17页

DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz

目的:报道开放性小腿骨折伤口闭合的处理经验。

方法:清创和处理骨折后,直接缝合伤口时应无张力,否则行减张缝合,创面有软组织,可游离植皮。套状撕脱皮肤可修复成中厚皮片行原位缝合。创面污染重宜延期Ⅰ期闭合。对骨质外露,宜采用筋膜皮瓣,肌(皮)瓣。感染创口需炎症控制后行伤口闭合。

结果:新鲜创口128例伤口闭合,仅皮片原位缝合出现7例坏死,经第二次手术创口闭合。63例感染创面经抗炎、植皮和组织瓣方法闭合。

结论:伤口闭合方法多,方式选择应遵循由简单到复杂的原则。

[关键词]:小腿开放骨折伤口闭合治疗学

The Managements of Open Leg Fractures

Abstract:

Objective:To report the experiences of wound closure for open leg fractures.

Methods:After debridement and routine management,several methods were performed as follows:If tension exists when direct suture was done,relaxation should be taken;If wound overlies soft tissues,skin graft can be considered;Glove torn skin should be restored to thick split skin and be sutured;Delayed primary suture is suitable for serious polluted wound;Fascia skin flap,muscle or skin flap should be used when the wound lying directly over a bone;Diminishing infection is the first step for the infected wound before the closure.

Results:128 cases of fresh wounds healed except 7 cases of thick split graft which were healed after second operation.63 cases of infected wound have been closed after anti inflammation,skin graft and tissue flaps.

Conclusion:There are many methods for wound closure.But the advisable method should be selected according to the size and deepness of the wound,if the simple method has advantage for heal,the multiple is not adopted.

KEYWORDS:Open leg fracture Wound closure Therapeutics

引用本文，请按以下格式著录参考文献：

中文格式:	汤晓正,李重学.小腿开放性骨折伤口处理[J].中国骨伤,2000,13(1):16~17
英文格式:	TANG Xiao zheng,LI Chong xue.The Managements of Open Leg Fractures[J].zhongguo gu shang / China J Orthop Trauma ,2000,13(1):16~17

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