13. Phẫu thuật tạo hình tổn thương bàn tay do rắn độc cắn

Abstract

To describe the local damages and evaluate the early results of plastic surgery for hand injuries caused by venomous snake bites. A cross-sectional descriptive study was performed on 30 patients diagnosed and treated for soft tissue hand injuries caused by venomous snakebite at the Department of Esthetic and Plastic of Bach Mai Hospital from January 2022 to December 2022. 60% of patients were bitten at the finger. 50% of all cases had hand tendons necrosisor bone necrosis of the fingers. There were 7 defects which were reconstructed by flaps or skin graft and 7 fingers were amputated primary; 7 defects were covered by skin grafts and 9 defects were reconstructed by local or free flap flaps at the secondary operation. Both skin grafts and 3 of 5 flaps created immediately at the primary surgery had bad results. All skin grafts and 7 of 9 flaps reconstructed during the secondary surgery gave good results. Clinical injuries caused by venomous snake bites on the hand are especially varied thus treatment and surgery must be selected accordingly to achieve good results The defects that were covered at the primary surgery gave poor results more often than when reconstructed at the secondary surgery after debridement and VAC.