RESUMO
The authors inform about their experience of employing controlled abacterial medium in 30 patients with severe forms of wound infection of the hand which developed after open injuries of the hand. There was a 3-fold reduction of the periods of preparation of the suppurative wounds of the hand for plastic closure and a 10% increase of the area of grafting of skin autotransplants.
Assuntos
Infecções Bacterianas/cirurgia , Traumatismos da Mão/complicações , Isoladores de Pacientes , Infecção dos Ferimentos/cirurgia , Infecções Bacterianas/etiologia , Humanos , Cuidados Pós-Operatórios , Cicatrização , Infecção dos Ferimentos/etiologiaRESUMO
An experience with the treatment of 63 patients with scalped one or several fingers is analyzed. A classification of such traumas is proposed. Plasty with an "acute" Filatow graft, pocket skin plasty, free skin plasty with a splitted transplant were used for completely scalped fingers. In cases with incompletely scalped fingers the decompression of tissues was performed which prevented circulatory alterations. Long-term results within 1-12 years were studied. Indications for each method are analyzed.
Assuntos
Traumatismos dos Dedos/cirurgia , Adulto , Amputação Traumática/patologia , Amputação Traumática/cirurgia , Feminino , Traumatismos dos Dedos/patologia , Seguimentos , Humanos , Masculino , Métodos , Necrose , Ruptura , Pele/patologia , Retalhos CirúrgicosRESUMO
Early necrectomy followed by skin plasty allows preserving impaired parts of the hand and working capacity of the patients in posttraumatic necrosis of soft tissues of the hand and fingers. The method of skin plasty and time of its fulfilling should be dependent on the character of injuries, their localisation and degree of necrosis. In the absence of wound infection skin plasty must be fulfilled immediately after necrectomy. In necrosis accompanied by suppuration skin plasty is indicated after preparing the wound surface with vacuum and ultrasonic treatment, controlled abacterial environment. Positive results of reestablishing working capacity were obtained in 88.6% of the patients examined in remote periods after treatment.