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首页> 美国卫生研究院文献>Hand (New York N.Y.) >Use of Integra in the Management of Complex Hand Wounds From Cancer Resection and Nonburn Trauma
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Use of Integra in the Management of Complex Hand Wounds From Cancer Resection and Nonburn Trauma

机译：积分在癌症切除和非烧伤性创面复杂伤口处理中的应用

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>Background: Despite extensive use of Integra in burn reconstruction, little has been published regarding its utility in complex hand wounds from nonburn trauma or cancer resection. This study aimed to review outcomes following Integra use for hand reconstruction following cancer resection or nonburn trauma with exposed bone, joints, and/or tendons. >Methods: Retrospective review was performed of patients undergoing hand reconstruction with Integra for exposed bones, joints, or tendons over a 6-year period at a single institution. >Results: Fourteen patients underwent hand reconstruction using Integra, 8 following cancer resection and 6 following acute nonburn trauma. The mean defect size was 19 cm2, 79% had exposed tendon without peritenon, 43% had exposed bone without periosteum, and 28% had exposed joint capsule. Mean time from Integra to skin graft was 11.3 days, and negative-pressure wound therapy did not significantly decrease the mean time from Integra to skin graft placement (P = .76). Overall, 13 patients achieved successful reconstruction with mean skin graft take of 97%, and 1 required revision amputation at the proximal interphalangeal (PIP) joint. Six months postoperative, 92% patients had return of preoperative hand function. Without any surgical revision, 85% of patients were extremely satisfied with the aesthetic result and 15% were fairly satisfied. >Conclusions: Integra is an effective method to treat complex hand wounds with exposed bone, joints, and/or tendons. This technique can be used in the office, lessens the need for local or free flap coverage, and provides an excellent aesthetic outcome. Integra should be considered a viable option in hand reconstruction algorithm.
机译：>背景：尽管Integra在烧伤修复中得到了广泛使用，但有关其在非烧伤创伤或癌症切除术造成的复杂手部伤口中的实用性的报道很少。这项研究的目的是回顾在癌症切除或不烧伤，骨骼，关节和/或肌腱裸露后使用Integra进行手重建后的结果。 >方法：回顾性研究了在单个机构中进行了6年内使用Integra对裸露的骨骼，关节或肌腱进行手重建的患者。 >结果： 14例患者使用Integra进行了手重建，癌症切除术后8例，急性非烧伤创伤后6例。平均缺损大小为19 cm 2 ，有79％的肌腱外露没有骨膜，有43％的骨露没有骨膜，有28％的关节囊有外露。从Integra到皮肤移植的平均时间为11.3天，负压伤口治疗并没有显着减少从Integra到皮肤移植的平均时间（P = .76）。总体而言，有13例患者成功完成了重建，平均皮肤移植率为97％，其中1例需要在指间近端（PIP）关节进行截肢术。术后六个月，有92％的患者恢复了术前手功能。如果不进行任何手术修改，则85％的患者对美学效果非常满意，而15％的患者相当满意。 >结论：Integra是治疗骨骼，关节和/或肌腱裸露的复杂手部伤口的有效方法。该技术可用于办公室，减少了局部或自由皮瓣覆盖的需要，并提供了出色的美学效果。集成应该被认为是手工重建算法中可行的选择。

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