Traumatic emergency call of hand Detail that can't be neglected

Traumatic emergency call of hand Detail that can't be neglected
Traumatic emergency call of hand Detail that can't be neglected
Ningxia Hui Autonomous Region the intersection of institute of traditional Chinese medicine and second traumatism, hand of China, Guo, chief physician of dept. of orthopedics, damage for many kinds of organizations more, such as the skin, bone, joint, tendon, nerve, blood vessel. Because the condition of the injury is relatively complicated, cause injury the reason and time of going to a doctor differ. It is comparatively thorny that surgery deals with the emergency call, whether each detail treated is correct and in time, it is essential for maintenance and appearance of the hand function to resume. Connect and examine and ask the medical history inspection Hand traumatism will be stressed when being handled " Urgent " Word. Can take, ask medical history method that check whether pay attention to, inquire, is injured time, condition of the injury, punishes the process, open dressing at the same time and observe the condition of the injury, check and point blood circulation of the tip, sense of pain and finger to crook and stretch the activity first, thus judge whether blood circulation, nerve and tendon rupture. Take a photograph of the exactly oblique location X-ray slice of hand conventionally, make preliminary diagnosis. Urgent to check four items of regular blood coagulation of blood, electrocardiogram, explain condition of the injury and healing solution to relatives, prepare for emergency call operation. Clear to create, organize, repair most key to create the intersection of decision and postoperative wound infect or not completely while being clear. Clear to achieve the skill and is divided into three steps: The first step, cover the wound properly with aseptic dressing, scrub the wound perimeter and pollute skin 3 times with the suds, rinse well with the physiological saline; The second step, with a large amount of physiological saline, hydrogen peroxide solution separately, dilute the iodine to bend over and develop repeatedly; The third step, sterilize and spread the piece of cloth conventionally, under the control of anaesthetizing and inflatable tourniquet, from the superficial to the deep, inwards, do carefully and clearly and create, find out the pollution situation and tissue range damaged from outside, excise inactivation to organize. Need to do the seriously polluted wound surface " The roll carpet type " It is created that clear. Repair under the microscope finishing the intersection of hand and traumatism repair, take exquisite and meticulous, practical, esthetic while being the first stage of. Handle fracture first, reset, generally use gram the needle is fixed when done. Stretch, mean tendon make add disconnected stitch by 8 word, count on one's fingers tendon adopt, improve the intersection of kessler and law, sew up. Because of meaning the nerve, meaning the diameters of the inherent artery do not exceed 1 millimetre, should repair the neural blood vessel under the operation microscope. If one side means the artery ruptures, refuses to repair. If both sides mean the inherent artery must repair one side to damage, two identical arteries are better. Close the wound and does not adopt the incomplete end and wrap up the plain mode buried easily. Skin little in defect,can take some skin petals small,for instance, mean neighbor by skin petal, mean whether there aren't artery; Defect can use among the bone carrying the intersection of side and the intersection of island and the intersection of skin and petal while being big and ulnar artery upgo prop up skin one,etc. shift and repair. Special wound treatment method variant persons or dogs bite: It is created that should be clear immediately, but the identical blood vessel that ruptures, sew up the tendon, nerve, the wound is guided open, change dressings every day, infect and control, the second stage of stitch walk or dissociate dermatoplastic by dispelling the wound surfacely in 5~7 days. Heat is weighed wounded: The treatment relies mainly on burning, often a plurality of fingers carry the skin defect of side, can excise the necrosis tissue, mean both sides create reason sew up each other, enable respectively meaning, giving a piggyback, forming a loud wound surface each, then repair by a cover one, separate the finger linked again in later period. It is wounded to inject under high pressure: Foreign matter must be removed completely, but should pay attention to avoiding to too many stimuli around the blood vessel, prevent meaning artery convulsion and ischemic, the wound should be fully guided. The avulsion of the whole glove is wounded: Make baggy cover one on the belly, bury palm, back of the hand and finger of the skin of avulsion under the cover one. Have technological terms, very the first stage of competent free the intersection of skin and petal transplant, repair also. In addition, should pay attention to observing the patient's whole body situation and supplement the blood capacity in time; Employ antibiotic and resist convulsion, anticoagulatory medicine; Keep 22~25 �� of room temperature, use the roast light if necessary; Observe blood luck, including skin, nail matrix color, the capillary is congested and reacted etc., discover the problems to deal with in time.


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