摘要
目的探讨一期瘢痕切除松解瘢痕后负压封闭引流,二期再行皮片移植治疗关节重度瘢痕挛缩的临床效果。方法2015年5月至2023年8月,陆军第七十三集团军医院烧伤整形外科收治的54例烧伤后关节挛缩畸形患者,挛缩关节活动度减少1/3以上,常规完善手术前检查,一期行瘢痕切除关节松解,负压封闭吸引1周后,二期中厚皮片移植修复创面,术后严格关节制动,继续予以负压治疗,9天后观察打开首次拆除负压观察皮片成活情况,术后3个月观察瘢痕及关节活动情况。结果54例患者在行两步法植皮后,皮片成活率都在95%以上,愈合后常规预防瘢痕治疗,3个月后随访瘢痕生长不明显,愈合后外观平整,未出现明显肌腱与皮片粘连情况,关节功能改善明显。结论对于严重瘢痕挛缩畸形,一期瘢痕松解,创面负压吸引优化创基后,二期植皮封闭,可提高皮片成活率,改善外观和功能,是比较适合基层临床单位推广使用的一种手术方法。
Objective To investigate the clinical effect on the treatment of scar contracture deformity by the way that skin graft after one week of negative pressure drainage the wound made by scar contracture release.Methods A total of 54 patients with scar contracture deformity that joint motion range reduced more than 1/3 admitted to Army 73rd Group Military Hospital from May 2015 to August 2023,we cover the wound that followed by scar contraction release with negative pressure drainage,one week later we close the wound with auto-skin grafting combined with negative pressure drainage again,the negative pressure was maintained around 300mmHg,observe the skin survival and joint motion range with follow–up of 3 months.Results All the skin slices survived more than 95 percent,the graft–skin surfaces were smooth,combined with function exercises after operation,the graft-skins had less scar and contracture.The function and appearance were signifificantly improved.Conclusions The way that released contracture combined with negative pressure drainage system before skin-graft can improve the graft-skin survival rate,function and appearance of severe scar contracture deformity,it is worthy of clinical promoting.
作者
杨新蕾
许建允
孟红阳
李金虎
雷磊
张新合
YANG Xinlei;XU Jianyun;MENG Hongyang;LI Jinhu;LEI Lei;ZHANG Xinhe(Department of Burn and Plastic Surgery,73rd Army Group Hospital,Fujian Province,361003,China)
出处
《中国医疗美容》
2024年第7期66-69,共4页
China Medical Cosmetology
关键词
瘢痕挛缩
负压封闭引流
皮片移植
畸形
scar contracture
negative pressure wound therapy
skin graft
deformity
