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目的 评价烧伤后用全厚皮片行眼窝再造术联合羟基磷灰石义眼座置入的疗效。方法 对 10例由于铁水、强酸、强碱及火药烧伤引起的眼窝闭锁进行手术治疗。其中已摘除眼球者 6例 ,有残留萎缩眼球者 4例。对 8例眼部烧伤患者行一期羟基磷灰石义眼座置入同时行全厚皮片移植眼窝再造术 ,2例为义眼座置入后二期行眼窝再造术。皮片取自上臂或大腿内侧 ,包裹自制眼模在置入羟基磷灰石义眼座后置入眼窝内 ,上下眼睑行睑缝合术 ,术后 6～ 10个月剪开睑缘 ,定制义眼片。结果 经 8～ 3 6个月 (平均 2 3 .2个月 )的随访 ,皮片均成活 ,义眼座无暴露 ,无继发感染 ,患眼上下穹窿形成好 ,放置义眼片后外观满意 ,无义眼片自行脱出现象。结论 对一些已无结膜组织的严重烧伤患者 ,用全厚皮片行眼窝再造术是较为有效的手术方法。
Objective To evaluate the curative effect of full-thickness skin flap combined with hydroxyapatite orbital implantation after burn wound. Methods Surgical treatment of 10 cases of orbital atresia caused by hot metal, acid, alkali and gunpowder burn. Among them, 6 cases of eyeballs have been removed and 4 cases of residual eyeballs have been shrunk. Eight patients with ocular burns underwent hydroxyapatite orbital implantation simultaneously with full-thickness skin grafting orbital reconstructive surgery. Two cases were treated with orbital implantation for two orbital reconstructions. Skin from the upper arm or thigh medial parcels of homemade eye into the hydroxyapatite into the eye socket into the orbit, the upper and lower eyelid line suture, cut the eyelid 6 to 10 months after the custom Eye piece. Results After follow-up of 8 to 36 months (mean, 23.2 months), all the skin flaps survived. There was no exposure of the prosthetic base and no secondary infection. The superior and inferior domes formed well and the appearance was satisfactory , Non-prosthetic eye out of their own phenomenon. Conclusion For some patients with severe burns without conjunctival tissue, full thickness skin rewop surgery is a more effective surgical method.