CAJ | 학술논문

背景：有研究表明，对于开放性骨折伴软组织缺损在不可能关闭软组织缺损和未找到可用的肌肉和肌皮瓣前，将负压封闭引流高分子泡沫材料作为人工替代皮肤覆盖创面是一种较好的方法。目的：观察高分子泡沫材料负压封闭引流修复足踝部皮肤软组织缺损的疗效。方法：选择25例足踝部皮肤软组织缺损患者，其中14例采用高分子泡沫材料负压封闭引流技术联合拉网植皮治疗，另11例采用传统换药联合植皮打包覆盖创面治疗。比较两组治疗的临床效果差异。结果与结论：负压封闭引流组中10例植皮完全成活，成活率为71%；另4例通过换药最终覆盖创面。传统换药组中6例植皮完全成活，成活率为55%；剩余5例中3例通过换药愈合，2例行二次植皮。两组植皮成活率差异无显著性意义(P >0.05)。负压封闭引流组等待二期手术时间、二期手术前换药次数及缺损完全修复时间均少于传统换药组(P <0.05)。提示高分子泡沫材料负压封闭引流技术可加快游离植皮修复足踝部皮肤软组织缺损创面愈合速度，缩短病程。
배경：유연구표명，대우개방성골절반연조직결손재불가능관폐연조직결손화미조도가용적기육화기피판전，장부압봉폐인류고분자포말재료작위인공체대피부복개창면시일충교호적방법。목적：관찰고분자포말재료부압봉폐인류수복족과부피부연조직결손적료효。방법：선택25례족과부피부연조직결손환자，기중14례채용고분자포말재료부압봉폐인류기술연합랍망식피치료，령11례채용전통환약연합식피타포복개창면치료。비교량조치료적림상효과차이。결과여결론：부압봉폐인류조중10례식피완전성활，성활솔위71%；령4례통과환약최종복개창면。전통환약조중6례식피완전성활，성활솔위55%；잉여5례중3례통과환약유합，2례행이차식피。량조식피성활솔차이무현저성의의(P >0.05)。부압봉폐인류조등대이기수술시간、이기수술전환약차수급결손완전수복시간균소우전통환약조(P <0.05)。제시고분자포말재료부압봉폐인류기술가가쾌유리식피수복족과부피부연조직결손창면유합속도，축단병정。
BACKGROUND:Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE:To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS:Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION:The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.