中国美容医学
中國美容醫學
중국미용의학
CHINESE JOURNAL OF AESTHETIC MEDICINE
2015年
6期
4-7
,共4页
杨洪%徐文举%孙羽飞%马常明
楊洪%徐文舉%孫羽飛%馬常明
양홍%서문거%손우비%마상명
阴囊坏疽%封闭负压引流(VSD)%股薄肌%治疗
陰囊壞疽%封閉負壓引流(VSD)%股薄肌%治療
음낭배저%봉폐부압인류(VSD)%고박기%치료
crotum defect%vacuum sealing drainage(VSD)%gracilis%treatment
目的：探索感染性阴囊缺损的修复方法。方法：选择2008年1月-2014年5月间南阳南石医院烧伤整形科收治阴囊坏疽4例，均采用早期清创+封闭负压引流+股薄肌岛状皮瓣转移模式修复。早期清创，清除坏死组织，保留精索及睾丸，应用封闭负压引流技术（vacuum sealing drainage，VSD)，控制感染，促进肉芽组织生长，创面清洁后应用股薄肌岛状皮瓣转移对感染性阴囊缺损行阴囊重建。记录伤口愈合等级，依生活满意度标准对生活满意度打分，记录伤口愈合时间。对手术前、手术后3月生活质量进行评分。结果：4例阴囊坏疽股薄肌岛状皮瓣转移术后全部愈合，3例甲级愈合,1例乙级愈合。其中1例合并耐药金黄色葡萄球菌感染，经应用替考拉宁针静滴及创面换药后愈合。4例均保留了睾丸，又再造了阴囊，外形皮肤色。满意度评分：3例非常满意,1例大体满意，原因自觉阴囊非原始阴囊有自卑感。住院时间24～36d，平均28.5d。术后生活质量明显提高（P<0.05）。术前、术后3个月在身体受限程度、躯体疼痛、综合健康、活力评分、社交功能、情感受限、心理健康等方面差异有统计学意义（P<0.05）。结论：早期清创应用封闭负压引流技术后联合股薄肌岛状皮瓣转移是感染性阴囊缺损阴囊重建的良好方法。
目的：探索感染性陰囊缺損的脩複方法。方法：選擇2008年1月-2014年5月間南暘南石醫院燒傷整形科收治陰囊壞疽4例，均採用早期清創+封閉負壓引流+股薄肌島狀皮瓣轉移模式脩複。早期清創，清除壞死組織，保留精索及睪汍，應用封閉負壓引流技術（vacuum sealing drainage，VSD)，控製感染，促進肉芽組織生長，創麵清潔後應用股薄肌島狀皮瓣轉移對感染性陰囊缺損行陰囊重建。記錄傷口愈閤等級，依生活滿意度標準對生活滿意度打分，記錄傷口愈閤時間。對手術前、手術後3月生活質量進行評分。結果：4例陰囊壞疽股薄肌島狀皮瓣轉移術後全部愈閤，3例甲級愈閤,1例乙級愈閤。其中1例閤併耐藥金黃色葡萄毬菌感染，經應用替攷拉寧針靜滴及創麵換藥後愈閤。4例均保留瞭睪汍，又再造瞭陰囊，外形皮膚色。滿意度評分：3例非常滿意,1例大體滿意，原因自覺陰囊非原始陰囊有自卑感。住院時間24～36d，平均28.5d。術後生活質量明顯提高（P<0.05）。術前、術後3箇月在身體受限程度、軀體疼痛、綜閤健康、活力評分、社交功能、情感受限、心理健康等方麵差異有統計學意義（P<0.05）。結論：早期清創應用封閉負壓引流技術後聯閤股薄肌島狀皮瓣轉移是感染性陰囊缺損陰囊重建的良好方法。
목적：탐색감염성음낭결손적수복방법。방법：선택2008년1월-2014년5월간남양남석의원소상정형과수치음낭배저4례，균채용조기청창+봉폐부압인류+고박기도상피판전이모식수복。조기청창，청제배사조직，보류정색급고환，응용봉폐부압인류기술（vacuum sealing drainage，VSD)，공제감염，촉진육아조직생장，창면청길후응용고박기도상피판전이대감염성음낭결손행음낭중건。기록상구유합등급，의생활만의도표준대생활만의도타분，기록상구유합시간。대수술전、수술후3월생활질량진행평분。결과：4례음낭배저고박기도상피판전이술후전부유합，3례갑급유합,1례을급유합。기중1례합병내약금황색포도구균감염，경응용체고랍저침정적급창면환약후유합。4례균보류료고환，우재조료음낭，외형피부색。만의도평분：3례비상만의,1례대체만의，원인자각음낭비원시음낭유자비감。주원시간24～36d，평균28.5d。술후생활질량명현제고（P<0.05）。술전、술후3개월재신체수한정도、구체동통、종합건강、활력평분、사교공능、정감수한、심리건강등방면차이유통계학의의（P<0.05）。결론：조기청창응용봉폐부압인류기술후연합고박기도상피판전이시감염성음낭결손음낭중건적량호방법。
Objective To explore the methods of repairing the defect of infectious scrotal. Methods During January 2008 to May 2014, four cases of scrotal gangrene were treated as follows:First clean the wound as early as possible,cover wound surface with vacuum sealing drainage (VSD),and then reconstruct scrotum with gracilis myocutaneous flap.The wound healing time and healing level was recorded.Life satisfaction in accordance with the standard of life satisfaction and the quality of life before operation and 3 months after operation was scored. Results All cases were cured, there were three cases with Class A healing, one cases with Class B healing, wherein one of them merger drug-resistant staph infections, the application of their steadying needle static drops and wound dressing after healing. The testes were retained, scrotum were reconstructed and appeared skin color in the four cases.Satisfaction rating: Three of the four cases were very satisfactory.One of the cases was general satisfactory.The reason was that he has an inferiority complex because the scrotum was not the original one. They stayed in hospital from 24 days to 36 days,averaging 28.5 days. Quality of life improved significantly after operation.(P<0.05). Conclusion It is effective to repair the defect of infectious scrotal using VSD combine gracilis myocutaneous flap as early as possible.
