[1]杨俊兴,陈建发,张华,等.形克氏针皮肤减张术治疗四肢软组织缺损[J].中医正骨,2016,28(04):42-43，46.
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形克氏针皮肤减张术治疗四肢软组织缺损()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第28卷
期数:
2016年04期
页码:
42-43，46
栏目:
临床报道
出版日期:
2016-04-20

文章信息/Info

作者:
杨俊兴; 陈建发; 张华; 刘付懿斐; 王海彬; 方斌
广州中医药大学第一附属医院,广东 广州 510405
关键词:
软组织损伤;  皮肤减张术;  克氏针
摘要:
目的:探讨自制“”形克氏针皮肤减张术治疗四肢软组织缺损的临床疗效和安全性。方法:2011年7月至2015年11月收治12例四肢软组织缺损患者,男10例、女2例; 年龄19～66岁,中位数41岁; 肿块切除术后3例、膝关节置换术后2例、截肢术后2例、跟腱断裂缝合术后2例、左胫骨慢性骨髓炎窦道形成1例、左胫腓骨内固定取出术后1例、右胫骨截骨术后1例; 软组织缺损面积3 cm×3 cm至10 cm×5 cm; 病程2～13个月,中位数6个月。对创口进行清创后,用直径1.5 mm克氏针在距一侧创面皮缘2～3 cm处从皮肤垂直穿入直至深筋膜,控制其在深筋膜下走行,穿入对侧软组织,在距对侧创面皮缘2～3 cm处穿出。将克氏针两端向心性牵引折弯,以创口双侧软组织能够实现无张力状态下聚合为度,然后将针尾及针尖分别折弯成“”形。根据创面大小确定克氏针数量,克氏针间距2 cm,将创口无张力下闭合后,根据创口张力和损伤程度选择一期闭合或逐渐牵张直至创面闭合或可直接缝合为止。结果:12例患者的创口均于术中实现无张力下闭合。所有患者均获随访,随访时间4～48个月,中位数36个月。术后创口均愈合,愈合时间12～21 d,中位数15 d。未发生感染、皮缘坏死、血肿形成及克氏针切割皮缘等并发症。末次随访时创口皮肤外观与感觉功能恢复良好,瘢痕较小。结论:应用“”形克氏针皮肤减张术治疗四肢软组织缺损,操作简单,可在术中实现无张力下闭合创口,创口愈合快,并发症少,可作为临床治疗四肢软组织缺损的一种治疗方案。

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备注/Memo

备注/Memo:
通讯作者:杨俊兴 E-mail:13725281666@163.com
更新日期/Last Update: 2016-08-30