四肢软组织损伤的综合治疗:一项为期 12 年的回顾性研究。

IF 2.2 3区 医学 Q3 CRITICAL CARE MEDICINE
Feiya Zhou, Xian Zhang, Yingying Zhang, Guangheng Xiang, Peng Luo, Wei Hu, Leyi Cai
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引用次数: 0

摘要

背景:四肢软组织损伤(DSTI)的严重程度往往被低估,给整形外科医生带来了巨大挑战。我们提出了一个全面的管理方案来规范重建方法,旨在成功治疗这些破坏性损伤:我们回顾性分析了 12 年间连续收治的四肢 DSTI 患者的数据。我们将患者分为三个年龄组(0-17 岁、18-65 岁和 65 岁以上),以突出不同年龄段的不同治疗方案。根据损伤模式,采用了不同的手术技术。根据年龄、基础条件和损伤类型,为每位患者制定了个性化的治疗策略。对伤口愈合、并发症和功能结果进行了记录:在住院患者中,20 人失去了随访机会,105 人被纳入分析。受伤时的平均年龄为 40 ± 44.9 岁,平均随访时间为 30.1 ± 12.7 个月。此外,19%的患者年龄在 0-17 岁之间,61%的患者年龄在 18-65 岁之间,20%的患者年龄在 65 岁以上。治疗方案根据伤情特征进行个性化设计,许多患者采用多种外科技术联合治疗。与其他年龄组相比,老年患者的伤口愈合时间明显更长,恢复日常生活的时间也更晚。总体而言,患者普遍对治疗效果感到满意。总并发症发生率为46.7%,其中79.5%为主要并发症。每种并发症都有针对性的治疗方案:结论:DSTI 的治疗应该因人而异,考虑到每种损伤的具体特点。年龄和健康状况在决定手术方法和预后方面起着至关重要的作用。准确的初步评估和彻底的清创对于取得最佳疗效至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive management of degloving soft tissue injuries of the extremity: A 12-year retrospective study

Background

Degloving soft tissue injuries (DSTIs) of the extremities, which are often underestimated in terms of their severity, present significant challenges to reconstructive surgeons. We propose a comprehensive management protocol to standardize the reconstructive approach, aiming for successful treatment of these devastating injuries.

Methods

We retrospectively analyzed data from consecutive patients with extremity DSTIs over a 12-year period. Patients were categorized into three age groups (0–17, 18–65, and >65 years) to highlight the different treatment options based on age. Various surgical techniques were employed depending on the injury pattern. Treatment strategies for each patient were individualized based on age, underlying conditions, and injury type. Wound healing, complications, and functional outcomes were recorded.

Results

Of the hospitalized patients, 20 were lost to follow-up, and 105 were included in the analysis. The mean age at the time of injury was 40 ± 44.9 years, with a mean follow-up of 30.1 ± 12.7 months. Furthermore, 19 % of patients were aged 0–17 years, 61 % were aged 18–65 years, and 20 % were aged >65 years. Treatment plans were personalized based on injury characteristics, with numerous patients being treated with a combination of multiple surgical techniques. Older patients had significantly longer wound healing times and delayed return to activities of daily living compared to the other age groups. Overall, patients were generally satisfied with their outcomes. The total complication rate was 46.7 %, with 79.5 % being categorized as major complications. Each complication was addressed with a tailored treatment plan.

Conclusion

The management of DSTIs should be individualized, taking into account the specific characteristics of each injury. Age and medical fitness play crucial roles in determining both the surgical approach and prognosis. An accurate initial evaluation and thorough debridement are essential for optimal outcomes.
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来源期刊
CiteScore
4.00
自引率
8.00%
发文量
699
审稿时长
96 days
期刊介绍: Injury was founded in 1969 and is an international journal dealing with all aspects of trauma care and accident surgery. Our primary aim is to facilitate the exchange of ideas, techniques and information among all members of the trauma team.
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