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[目的]探讨小儿四肢皮肤撕脱伤的治疗体会。[方法]彻底清创,创面处理根据皮肤撕脱采伤的特点,自体大块游离皮片植皮42例,局部转移皮瓣加植皮21例,撕脱皮肤处理后原位再植15例,术后加强抗感染等对症处理。[结果]78例患者皮瓣完成活率95%以上,无皮肤组织感染,功能恢复良好;7例患者有部分皮肤坏死(成活率85%～90%),经换药处理后均完全愈合;二期植皮26例,原位再植坏死后大块异体皮加自体微粒皮移植1例,予再次清创处理,创面新鲜后二次手术植皮,愈合良好,功能恢复较好。[结论]根据小儿四肢皮肤撕脱伤的特点,采取相应的植皮方式,均能起到良好的术后恢复效果。
[Objective] To explore the treatment of skin avulsion in children with limbs. [Method] Thorough debridement and wound treatment According to the characteristics of skin avulsion injuries, there were 42 cases of autologous bulk skin graft, 21 cases of local transfer flap and skin graft, 15 cases of orthotic skin replantation After strengthening anti-infection symptomatic treatment. [Result] The skin flap of 78 patients completed more than 95% survival rate, no skin infection and good functional recovery. Some of the 7 patients had partial skin necrosis (85% -90% survival rate) and completely healed after dressing change. Two cases of skin grafting in 26 cases, in situ replantation and necrosis after massive autologous skin graft autograft skin graft in 1 case, once again debridement treatment, fresh wounds after two surgical skin grafting, healing well, better functional recovery. [Conclusion] According to the characteristics of avulsion of limbs and limbs in children, adopting the corresponding skin grafting method can all play a good postoperative recovery effect.