摘要
目的探讨三种不同方法应用于上肢大面积软组织损伤修复的效果。方法 30例发生上肢大面积缺损的患者随机分为A、B、C三组,A组行下腹部与股前外侧皮瓣联合修复,B组采用负压封闭引流(Vacuum sealing drainage,VSD)覆盖后创面二期修复,C组采用串联或并联皮瓣修复加二期功能重建。术后1年定期随访各组患者术后皮瓣循环障碍、血管肌腱粘连、感染、骨髓炎、皮肤组织坏死、瘢痕组织增生发生率,进行手功能恢复评分。对比三组患者的换药频率、创面缩减程度。结果术后3周皮瓣循环障碍、肌腱粘连、皮肤组织坏死、感染、瘢痕组织增生,A组与B组、C组比较,均存在显著差异(均P<0.05);术后A组患者的手功能恢复评分显著高于B组和C组(均P<0.05)。结论下腹部与股前外侧皮瓣联合修复上肢大面积软组织损伤,临床效果优于VSD覆盖后创面二期修复和串联或并联皮瓣修复加二期功能重建。
Objective To evaluate the medicinal effects of three different techniques as applied to the treatment of large portion of the upper limbs with severe soft tissue injury.Method 30 patients suffering soft tissue wounds in large portions of the upper limbs were randomly divided into three groups, namely, group A, group B, and group C.Group A were treated with the lower abdomen and anterolateral femoral flap combined with repair; Group B were treated with Vacuum Sealing Drainage （ VSD） after covering two-stage repair of wound, and group C were treated with series or parallel flap repair and two-stage function reconstruction.Follow-ups were conducted one year after treatment for the patients for possible incidence of postoperative flap circulation disorder, vascular tendon adhesion, infection, osteomyelitis, skin necrosis, and scar tissue hyperplasia.The effects of the different techniques were evaluated and compared on the frequency of renewal of medicine and the reduction in the size of wound.Findings Three weeks after treatment, the difference in the incidence of flap circulation disorder, sequential adhesion of tendon, skin necrosis, infection, and scar tissue hyperplasia as observed in the three groups, was significant （P〈0.05）, with best recovery of hand function in group A as compared to that in either group B or group C （P〈0.05）.Conclusion Abdominal and femoral anterolateral flap combined with repair as a medicinal technique in healing soft-tissue wounds in large portions of upper limbs was found to be superior to the other techniques as applied to group B or group C.
出处
《健康研究》
CAS
2015年第2期156-158,共3页
Health Research
基金
2012年苍南县科技计划项目(2012S16)
