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目的总结小儿手部严重鞭炮炸伤显微外科修复的经验。方法26例均采用显微外科方法进行处理,急诊一期修复23例,延迟修复3例,临床上根据不同的伤情采用不同的手术方法。结果本组再造拇指及移植皮瓣均成活,伤口均Ⅰ期愈合;断指再植9例11指,成活7例9指,失败2例2指。经2年随访,手部外形及生长发育正常,对掌对指功能良好。结论在小儿手部严重爆炸伤时应尽早采用显微外科方法进行修复与重建,同时术前选择合适的修复与重建方案对于手术后效果也是非常重要的。
Objective To summarize the experience of microsurgical repair of serious firecracker injuries in children’s hands. Methods Twenty-six cases were treated by microsurgical method. In the first stage of emergency, 23 cases were repaired and 3 cases were delayed repaired. According to different injuries, different surgical methods were used clinically. Results In this group, the thumb and graft flap survived. All the wounds healed in the first stage. There were 11 fingers in 9 cases, 9 fingers in 7 cases and 2 cases in 2 cases. After 2 years of follow-up, the hand shape and growth and development of normal, right palm to finger function well. Conclusion Microsurgical repair and reconstruction should be carried out as early as possible in children with severe explosive hand injuries. At the same time, it is very important to choose appropriate repair and reconstruction before surgery for the postoperative effects.