Clinical Experiences in Treatment of Heat-Press Injury of Pediatric Hand by Automatic Cup-sealing Machine

自動杯型封口機造成孩童手部接觸性熟傷害治療之臨床經驗

林鴻祥(Hung-Hsiang Lin) ； 黄文成(Wen-Chen Huang) ； 董光義(Kwang-Yi Tung) ； 陳恆常(Heng-Chang Chen)

《中華民國整形外科醫學會雜誌》 15卷2期 (2006/06) Pp. 160-167

https://doi.org/10.7096/JPSA.200606.0160

摘要

自動杯型封口機目前在坊間被廣泛的使用，家長因工作的繁忙及疏於對孩童的照顧，又因為小孩好奇心的驅使下把手放在機器上，意外往往就這樣發生。這類機器封口時接觸面的溫度高（攝氏150-170度）時間長（約3秒），對於孩童的手背造成無法預測的傷害。此種傷害發生的頻率有上升的趨勢，對於這類接觸性熱傷害的傷患我們提出了三例不同深度的臨床經驗和治療結果：在第一例和第二例屬於深二度至三度的接觸性燙傷，我們以早期清創並覆蓋以植皮或皮瓣的方式治療癒後不錯；第三例屬於四度的接觸性燙傷，不僅造成手指部份壞死及指關節損傷雖然後來以皮瓣治療但癒後手部功能並不理想。我們則建議對於更深及肌腱、指骨及關節的傷害，要早期的清創並積極地以皮瓣重建的方式來搶救。分享這些病例的同時，也希望提醒人們對這類可預防的幼童手部接觸性燙傷，避免意外再度發生。

並列摘要

Automatic cup-sealing machines (semi- and full automatic type) were used extensively among workshop and unexpected emergence is often caused by the carelessness of parents and the curiosity of children. We introduce our experiences in treating 3 cases of different depth of injury on their dorsal hand with different strategies. In our first and second cases with good prognosis, early debridement and resurfacing with either skin graft or flap could be good choice of the treatment for deep second degree to third degree burn injury. But in our third case revealed poor outcome even if late flap coverage post-burn day 14. We suggest that, for those who had deeper injury with the tendon and phalangeal bone/joint involved, early debridement and aggressive flap reconstruction was indicated for salvage. These cases were brought up not only the experiences sharing in such disease entity, but reminding us of a preventable type of contact burn in pediatric hand injury.

並列關鍵字

Automatic cup-sealing machines semi- and full automatic type ； heat-press injury ； pediatric hand