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首页> 美国卫生研究院文献>Annals of Surgery >Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.
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Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.

机译：儿童急性手灼伤：根据十年的经验对698例受伤的手进行处理和取得长期成果。

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OBJECTIVE: To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA: Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-term outcomes associated with such a plan of care have not been previously reported. METHODS: Over a 10-year period, 495 children with 698 acutely burned hands were managed at a regional pediatric burn facility; 219 children with 395 injured hands were followed in the authors' outpatient clinic for at least 1 year and an average of >5 years. The authors' approach to the acutely burned hand emphasizes ranging and splinting throughout the hospital stay, prompt sheet autograft wound closure as soon as practical, and the selective use of axial pin fixation and flaps. Long-term follow-up, hand therapy, and reconstructive surgery are emphasized. RESULTS: Normal functional results were seen in 97% of second-degree and 85% of third-degree injuries; in children with burns involving underlying tendon and bone, 70% could perform activities of daily living and 20% had normal function. Reconstructive hand surgery was required in 4.4% of second-degree burns, 32% of third-degree burns, and 65% of those with injuries involving underlying bone and tendon. CONCLUSIONS: When managed in a coordinated long-term program, the large majority of children with serious hand burns can be expected to have excellent functional results.
机译：目的：记录与儿童急性灼伤手协调治疗计划相关的长期结果。摘要和背景数据：最佳手部功能是烧伤后高质量生存的关键组成部分。这只能通过对伤害采取协调一致的方法来实现。先前尚未报道与这种护理计划相关的长期结果。方法：在10年的时间里，在区域小儿烧伤设施中对495名患698手严重烧伤的儿童进行了治疗。在提交人的门诊中对219名儿童的395手受伤的儿童进行了至少1年，平均> 5年的随访。作者对严重烧伤的手的处理方法强调在整个住院期间应进行范围调整和夹板固定，在可行的情况下尽快关闭自体薄片自体伤口，并选择使用轴向销钉固定和皮瓣。强调长期随访，手部治疗和重建手术。结果：97％的二级损伤和85％的三级损伤均可见正常的功能结果；在患有涉及下肢肌腱和骨骼的烧伤的儿童中，70％的人可以进行日常生活活动，而20％的人功能正常。 4.4％的二级烧伤，32％的第三级烧伤和65％的涉及下层骨骼和肌腱受伤的患者需要进行手部重建手术。结论：如果在长期的协调性计划中进行管理，大部分被严重烧伤的儿童有望获得出色的功能效果。

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