中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
2期
194-196
,共3页
陈道振%赵志坚%陈坤峰%丁丁%朱鑫%郭伟杰
陳道振%趙誌堅%陳坤峰%丁丁%硃鑫%郭偉傑
진도진%조지견%진곤봉%정정%주흠%곽위걸
皮肤移植%上肢皮肤脱套伤%负压封闭引流
皮膚移植%上肢皮膚脫套傷%負壓封閉引流
피부이식%상지피부탈투상%부압봉폐인류
Skin transplantation%Degloving injury of skin,upper limbs%Vacuum sealing drainage
目的 探讨原位回植联合负压封闭引流(VSD)治疗上肢大面积皮肤脱套伤的疗效.方法 16例上肢大面积皮肤脱套伤患者(治疗组)清创后修剪脱套伤皮肤,结合应用含真皮下血管网皮片和中厚皮片原位回植,皮片表面用多聚乙烯醇明胶海绵材料覆盖封闭,24 h不间断负压吸引.同期20例对照组患者,植皮完毕后,无菌辅料打包加压.治疗组使用VSD 7 ～ 10 d后去除负压引流装置,检查皮片愈合情况；对照组1周后拆开加压敷料,检查皮片愈合情况.比较2组Ⅰ期植皮愈合率、换药次数和住院时间.结果 16例患者平均使用VSD 7 d,回植皮肤全部成活12例,4例成活90.0％～ 95.0％,外观和功能恢复均满意.治疗组与对照组在Ⅰ期植皮愈合率、换药次数和住院时间等方面差异均有统计学意义[(96.0±2.5)％比(83.0±4.6)％,(4±1)次比(11±2)次,(13.0±3.5)d比(22.0 ±5.5)d,均P＜0.01].结论 脱套皮肤反取皮原位回植联合VSD处理上肢大面积皮肤脱套伤能Ⅰ期关闭创面,促进皮片与创面的良好贴附,皮片存活率高,外观和功能恢复满意,是治疗上肢大面积皮肤脱套伤的较好方法.
目的 探討原位迴植聯閤負壓封閉引流(VSD)治療上肢大麵積皮膚脫套傷的療效.方法 16例上肢大麵積皮膚脫套傷患者(治療組)清創後脩剪脫套傷皮膚,結閤應用含真皮下血管網皮片和中厚皮片原位迴植,皮片錶麵用多聚乙烯醇明膠海綿材料覆蓋封閉,24 h不間斷負壓吸引.同期20例對照組患者,植皮完畢後,無菌輔料打包加壓.治療組使用VSD 7 ～ 10 d後去除負壓引流裝置,檢查皮片愈閤情況；對照組1週後拆開加壓敷料,檢查皮片愈閤情況.比較2組Ⅰ期植皮愈閤率、換藥次數和住院時間.結果 16例患者平均使用VSD 7 d,迴植皮膚全部成活12例,4例成活90.0％～ 95.0％,外觀和功能恢複均滿意.治療組與對照組在Ⅰ期植皮愈閤率、換藥次數和住院時間等方麵差異均有統計學意義[(96.0±2.5)％比(83.0±4.6)％,(4±1)次比(11±2)次,(13.0±3.5)d比(22.0 ±5.5)d,均P＜0.01].結論 脫套皮膚反取皮原位迴植聯閤VSD處理上肢大麵積皮膚脫套傷能Ⅰ期關閉創麵,促進皮片與創麵的良好貼附,皮片存活率高,外觀和功能恢複滿意,是治療上肢大麵積皮膚脫套傷的較好方法.
목적 탐토원위회식연합부압봉폐인류(VSD)치료상지대면적피부탈투상적료효.방법 16례상지대면적피부탈투상환자(치료조)청창후수전탈투상피부,결합응용함진피하혈관망피편화중후피편원위회식,피편표면용다취을희순명효해면재료복개봉폐,24 h불간단부압흡인.동기20례대조조환자,식피완필후,무균보료타포가압.치료조사용VSD 7 ～ 10 d후거제부압인류장치,검사피편유합정황；대조조1주후탁개가압부료,검사피편유합정황.비교2조Ⅰ기식피유합솔、환약차수화주원시간.결과 16례환자평균사용VSD 7 d,회식피부전부성활12례,4례성활90.0％～ 95.0％,외관화공능회복균만의.치료조여대조조재Ⅰ기식피유합솔、환약차수화주원시간등방면차이균유통계학의의[(96.0±2.5)％비(83.0±4.6)％,(4±1)차비(11±2)차,(13.0±3.5)d비(22.0 ±5.5)d,균P＜0.01].결론 탈투피부반취피원위회식연합VSD처리상지대면적피부탈투상능Ⅰ기관폐창면,촉진피편여창면적량호첩부,피편존활솔고,외관화공능회복만의,시치료상지대면적피부탈투상적교호방법.
Objective To investigate the treatment effects with back implantation of skin combined with vacuum sealing drainage (VSD) on large degloving injury of skin of upper limbs.Methods Sixteen cases ( the treatment group) had back implantation with subdermal vascular network grafts or split-thickness skin grafts after debridement.The wound surface was filled with polyvinyl alcohol foams and continuous negative pressure drainage was taken for 24 h.Twenty cases of the control group had skin grafting after sterile materials with packing pressure.The treatment group used VSD for 7 to 10 d after the removal of negative pressure drainage device.Examination of skin graft healing was done.The control group after 1 week was removed of pressure dressing and examination of skin graft healing was done.Skin graft healing rate,frequency of dressing changes and the average length of stay of two groups were compared.Results The average time of VSD was 7 days.Twelve cases recovered completely.The flap survival rate in 4 cases was 90％ -95％.The Ⅰ phase of skin graft healing rate,frequency of dressing changes,the average length of stay and other aspects of the differences in the treatment group and the control group were statistically significant [ (96.0 ± 2.5 ) ％ vs ( 83.0 ± 4.6 ) ％,(4 ± 1 ) times vs ( 11 ± 2 ) times,( 13.0 ± 3.5 ) days vs ( 22.0 ±5.5) days,P ＜ 0.01 ].Conclusion The large skin degloving wound can be closed by back implantation of skin combined with VSD,which is a crediable treatment of limbs skin-degloving wound.
