《口腔颌面外科杂志》

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面部犬咬伤的治疗经验总结

朱黎, 王岭枫, 王志成, 文毅, 陈春华   

  1. 云南省西双版纳傣族自治州人民医院颌面外科,云南 西双版纳 666100
  • 出版日期:2017-10-28 发布日期:2019-03-26
  • 通讯作者: 朱黎,副主任医师. E-mail: 13988155366@163.com
  • 作者简介:朱黎(1975—),云南人,副主任医师,学士.

The Management Strategy of Dog Bites in the Face

ZHU Li, WANG Ling-feng, WANG Zhi-cheng, WEN Yi, CHEN Chun-hua   

  1. Department of Plastic Surgery, Peoples’ Hospital of Xishuangbanna, Xishuangbanna Autonomous Prefecture 666100, Yunnan Province, China
  • Online:2017-10-28 Published:2019-03-26

摘要:

目的:回顾面部犬咬伤的整形外科处理经验,提高面部犬咬伤的治疗水平。方法:回顾性分析2008-01—2015-12我院颌面外科诊治的65例面部犬咬伤患者。对所有患者接种狂犬疫苗,清创处理,一期缝合,其中53例患者直接缝合,对于12例(18.5%)软组织缺损较大的患者予以局部转移皮瓣修复。结果:伤口甲级愈合62例,伤口感染3例,经清创后延期再次缝合。术后随访6个月~3年,63例患者面部外观和功能基本恢复正常,患者满意;2例患者术后伤口瘢痕明显,患者不满意,术后8、12月再次瘢痕切除,修正后满意。结论:对于面部犬咬伤患者,按照整形外科原则,小的软组织损伤直接清创缝合,软组织缺损较大者采取邻近皮瓣转移术一期修复,可取得满意的效果。

关键词: 面部, 犬咬伤, 整形外科, 治疗

Abstract:

 Objective: To discuss and summarize the management tactics of plastic surgery in the treatment of facial dog bites injuries. Methods: From January 2008 to December 2015, 65 patients(30 males and 35 females) with facial dog bite injuries treated in the plastic surgery department were retrospectively reviewed. The patients aged from 12 months to 80 years, with a mean of 14 years. The time interval from injury to first aid treatment ranged from 15 minutes to 18 hours, with a mean of 3 hours. Most of the injuries were simple soft tissue damage, and 25 cases (38.5%) combined with soft tissue defects. All patients were proceeded with rabies immunization, wound debridement and primary suture, of which 53 cases were closed with simple plastic surgery suture and 12 cases (18.5%) with large soft tissue defects restored with local flaps. Results: Antibody immunization were successful in all cases. After 6 months to 2 years follow-up, 62 cases with primary healing and 1 case with delayed healing, all had satisfactory functional and esthetic effects. 2 cases with delayed healing also achieved  satisfactory functional and esthetic effect after scar revision. ConcIusion: For facial dog bite injuries, immunization first in first-aid treatment. Primary wound closure with plastic surgical technique can be performed for simple soft tissue injuries, and large soft tissue defects  could restorated with local flaps. In this way, a satisfactory prognosis.can be achieved.

Key words: face, dog bite injuries, plastic surgery, treatment

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