面部脱套伤.ppt

Facial degloving injury 面部脱套伤 Reported by lifesaver 汇报人:生命医号 Degloving injury ? Definition : degloving is skin and subcutaneous tissue detachment, most often affecting the limbs and extremities and occasionally the scalp ? Steming from: high-energy trauma, traffic or industrial accidents, but also be intentional, such as degloving approach in oral maxillofacial surgery Some cases about facial degloving injury 部分图片可能引起不适,建议请勿在进食时观看,胆小勿看。 Case 1 ? A 30-year-old white woman was the victim of severe facial trauma stemming from a rollover automobile accident 。? 9h after accident, the patient was conscious( 有意识的), oriented( 定向的), pale( 苍白的), tachypneic (呼吸急促的), tachycardic (心博过速的) Fig. 1. (A) Frontal view of the patient with facial flap down munication between the nasal and oral cavities after severe trauma; (B,C ) right and left profiles of the patient. Note that the whole mouth and a large fragment of jaw were kept in place only by the soft tissue of the al vestibule .T reatment ? Under general anaesthesia through the tracheostomy (气管造口术,气切) ? Exploration and rigorous surgical cleaning of the extensive facial wound and hemostasis( 止血) of the injured vessels were performed ? Blood volume reestablished with 2000 ml of lactated Ringer ’ s solution and two red blood cell concentrates Primary surgery ? Reconstruct the nasal structures to allow permeability of the upper airways, ?R eposition the extrinsic musculature of the orbits ? Reposition the maxilla through maxillomandibular fixation with Erich arch bars for the maintenance of the dental arches. ? The only bone fractures treated were those that were exposed by the trauma : anterior wall of the frontal sinus, left zygomatic arch and nasal bones (A, B) The patient after copious washing of the wound with saline, removal of devitalized tissue and fixation of fractures of the frontal bones and nasal and left zygomatic arches with titaniu