儿童手严重爆炸伤皮肤缺损的早期处理（附68例分析）

目的：降低儿童手严重爆炸伤的感染率与致残率。方法：对６８例儿童手严重爆炸伤皮肤缺损的直接定位缝合、短缩指骨缝合、皮瓣修复以及开放伤口二期修复等处理方法进行分析。结果：以开放创口换药有效率最高，占伤口总数的８９．６％，以腹壁带蒂皮瓣修复方法最低，占伤口总数的２６．３％。结论：儿童手严重爆炸伤皮肤缺损的一期修复方法应视创面具体情况而定，早期处理要以晚期修复手功能作准备。

EARLY TREATMENT FOR SEVERE HAND WOUND CRACKED BY ACCIDENTAL EXPLOSION IN CHILDREN (AN ANALYSIS OF 68 CASES)

Objective: To select the best treatment for severe hand cracked wound caused by accidental explosion in children. Methods: The effects of four procedures, including direct located sewing, shortening phalange sewing, immediate abdominal flap repair, and exchanging dressings on open wound for a few days before repairing the wound with flap, were compared in 68 cases of the victims. Results: The fourth procedure, the effective rate of which was as high as 89. 6 %,was superior to other ones, while the third procedure, the effective rate of which was merely 26. 3 %,was the worst. Conlusion: one-stage repair for severe hand cracked wound in children should depend on the wound conditions,and early management should prepare for following functional resteration of the wounded hand.