摘要
Abstract
Objective To explore the clinical efficacy of replantation of full-thickness skin graft for treatment of large area skin avulsion injury of extremities involving joints.Methods Fifteen patients with extensive skin avulsion of ex-tremities involving joints were treated with full-thickness skin graft.The survival of replanted skin graft was recorded.The scar appearance was assessed with the Vancouver Scar Scale(VSS),and neurosensory function recovery were e-valuated by Highet evaluation system.According to the different joints involved,the joint function was evaluated by knee joint HSS score,AOFAS ankle-hindfoot score,elbow modified Cassebaum score and wrist Cooney score.Results All patients were followed up for 1～5 years.①Survival condition of full-thickness replanted skin graft at 1 month after operation:excellent in 14 cases and fair in 1 case.②The scar appearance was assessed with VSS at 1 year after operation:satisfactory in 11 cases,fair in 4 cases.③At 1 year after operation,the neurosensory function assessed with Highet evaluation system:grade S4 in 5 cases,grade S3 in 9 cases,grade S2 in 1 case.④At postoperative 1 year,HSS scores of 9 cases involving knee joints were excellent in 2 cases,good in 5 cases,fair in 1 case and poor 1 case;in the 2 cases involving ankle joint,1 case was excellent by AOFAS ankle-hindfoot score,and 1 case was amputated;the 5 cases with elbow joint involvement were assessed with the modified Cassebaum score,the results were excellent in 1 case,good in 3,and fair in 1;the 1 case with wrist joint involvement was good by Cooney score.Conclusions Re-plantation of full-thickness skin graft for the treatment of large area skin avulsion of joints involved in extremities is a simple and easy method with a high survival rate,and satisfactory results can be achieved in appearance and sensa-tion.Early functional exercise after skin graft survival can promote the recovery of joint function.关键词
大面积皮肤撕脱伤/累及关节/全厚皮片/回植/负压封闭吸引技术Key words
large area skin avulsion injuries/involving joint/full-thickness skin graft/replantation/vacuum sealing drainage分类
医药卫生
