摘要
目的探讨负压封闭引流技术治疗大面积皮肤撕脱伤的临床疗效。方法对本院2007年3月—2010年8月采用原位全厚皮片回植方法治疗的62例大面积皮肤撕脱伤病例进行回顾性研究,其中多聚乙烯醇明胶海绵覆盖回植皮片、持续负压封闭吸引(负压引流组)35例,传统敷料加压包扎覆盖回植皮片(敷料加压组)27例。观察两组术后皮片成活情况、创面感染率和创面愈合效果,记录平均住院时间。结果负压引流组中有31例回植全厚皮片全部成活,皮片成活率88.6%,余4例皮片存活面积>95%,;2例遗留创面感染,感染率5.7%;平均住院时间(12.3±5.4)d。敷料加压组全部成活18例,皮片成活率66.7%,余9例皮片成活面积>75%;6例遗留创面感染,感染率22.2%;平均住院时间(19.7±8.3)d。对两组皮片成活率、创面感染率和平均住院时间进行比较,差异均有统计学意义(P<0.05)。两组经换药或二次手术植皮后,撕脱创面均愈合。结论与常规敷料加压包扎技术比较,封闭负压引流技术可提高大面积皮肤撕脱伤创面植皮的成活率,降低感染率,缩短住院天数,是治疗大面积皮肤撕脱伤较为理想的方法。
Objective To investigate the effect of vacuum sealing drainage （VSD） technology for the treatment of large area of skin avulsion injury. Methods In this retrospective study, 62 patients with large area skin avulsion injury were treated by in situ full-sickness skin graft replantation method in our hospital from March 2007 to August 2010. Among them, 27 patients were used with traditional pressure dressing （control group）, and 35 patients with VSD （VSD group）. Postoperative skin graft survival condition, wound surface infection and average hospital stay were recorded. Results In VSD group, the full-thickness skin graft survived completely in 31 cases （88.6%） while the skin survival area was higher than 95% in the other 4 cases, and there were 2 cases presented wound surface infection （infection rate was 5.7%）. In control group, the full-thickness skin graft of 18 cases presents survived completely （66.7%） while the skin survival area was higher than 75% in the other 9 cases, and there were 6 cases presented wound surface infection （infection rate was 21.4%）. Between two groups, there were statistical differences of skin graft survival rate and wound infection rate （P0.05）, also, the average hospital stay in VSD group was shorter than that in control group [（12.3 ± 5.4） d vs （19.7 ± 8.3） d, P 0.05]. After dressing change or the second skin grafting, all patients＇ wound surfaces healed completely. Conclusions Compared with traditional pressure dressing technique, VSD technique has the advantage of improving thesurvival rate of full-thickness skin graft, reducing infection rate and shortening average stay. As a result, VSD is a comparable good method for the treatment of large area skin avulsion injury.
出处
《中国骨科临床与基础研究杂志》
2011年第2期97-100,共4页
Chinese Orthopaedic Journal of Clinical and Basic Research
关键词
负压伤口疗法
引流术
皮肤移植
皮肤撕脱伤
Negative-pressure wound therapy
Drainage
Skin transplantation
Skin avulsion injury
