PHẪU THUẬT GHÉP DA ĐIỀU TRỊ KHUYẾT PHẦN MỀM VÙNG BÀN TAY DO RẮN HỔ MANG CẮN

Abstract

Objective: To evaluate the results of plastic surgery to cover hand soft tissue defects caused by cobra bites using skin grafting. Methods: Describes a cross-sectional study on 21 patients bitten by cobras in areas of the hand with defects covered by skin grafts at the Department of Aesthetic Plastic Surgery of Bach Mai Hospital from January 2022 to July 2023. Results: The location of the cobra bite involved the fingers in 11 of 21 patients (52.4%) and the wrist in 10 of 21 patients (47.6%). Most patients bitten by cobras only had localized necrosis in the bitten area in 15 of 21 patients (71.4%), 6 of 21 patients (28.6%) had additional lesions extending centrally. Four of 21 patients (19.05%) had excision and skin grafting in a single session, with an average hospital stay of 18.5 days. Three-forths of the skin grafting in those patients survived completely and 1 patient had poor skin graft adhesion and slow healing of the incision edges. Seveteen out of 21 patients (80.95%) received skin grafting, secondary to excision and placement of a negative pressure suction system. The average hospital stay was 23.6 days, 10 of 17 patients with skin grafts that survived completely, 5 out of 17 patients had skin grafts with 80% survial and 2 patients with skin grafts had poor adhesion and slow healing of the incision edges. Conclusion: Most defects caused by cobra bites after skin excision require care to prepare the foundation for skin graft surgery. Skin graft surgery is a simple method, has good coverage if the lesions are extensive, and does not damage tendons and bones.