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目的探讨儿童头颈部深度烧伤的治疗方法和疗效。方法创面采用暴露疗法,头皮Ⅲ度创面去痂后行局部皮瓣转移修复或行游离皮片移植。伤后3周,颜面部创面剥痂、削痂或刮除肉芽组织后分区行自体中厚皮移植术,颈部Ⅲ度同样移植自体中厚皮。创面愈合后行康复治疗。结果所有皮片移植手术均获得成功。颜面部外观丰满、皮肤富有弹性,缝接处有增生性瘢痕,全颜面深度烧伤者有不同程度的眼睑外翻、小口畸形、鼻翼畸形等。颜面部自愈创面压迫治疗区域瘢痕增生轻微。颈部深Ⅱ度创面后有不同程度瘢痕增生;植皮区无明显瘢痕增生,活动自如。结论儿童头颈部的深度烧伤创面移植中厚皮可获得较为满意的疗效,创面愈合后康复治疗同样至关重要,遗留的畸形或功能障碍可行整形手术解决。
Objective To investigate the treatment and efficacy of deep head and neck burn in children. Methods The wounds were treated with exposure therapy. The third degree scalp wounds were treated with local skin flap transfer or free skin graft. 3 weeks after injury, the facial wounds were scabbed, the callus was removed or granulation tissue was removed, and the autologous mid-thickness skin grafting was performed. The third grade of the neck was also transplanted into the mid-thick skin. Wound healing rehabilitation treatment. Results All skin grafts were successful. Face facial fullness, rich skin elasticity, sewing at the Department of hypertrophic scars, full face depth burns have varying degrees of eyelid valgus, small mouth deformities, nasal deformities and so on. Face facial self-healing wounds oppression area scarring mild hypertrophy. There was scar hyperplasia in deep Ⅱ degree wound on the neck; scar scar hyperplasia and freedom of movement in skin graft area. Conclusion Deep head and neck burn wounds in the transplantation of thick skin can be more satisfied with the effect of healing after wound healing is also crucial, residual deformity or dysfunction may be plastic surgery.