大张中厚皮片用于四肢大感染创面的修复

A Large Piece of Mid-thick Skin Used to Mend Limbs with a Serious Infected Gaping Wound

目的 观察四肢大感染创面彻底扩创后用大张中厚皮片植皮修复的疗效。方法 对 33例四肢大感染创面彻底扩创 ,有肌腱或骨外露的用肌瓣或筋膜瓣局部转移覆盖 ,采用大张中厚皮片加压打包植皮修复。结果 皮片成活率 90 %以上者 2 8例 ,占 84 .8% ,皮片成活率 6 0 %～ 89%者 5例 ,占 15 .2 % ,所有病例皮片移植后经 1～ 2周换药创面均愈合。结论 创面修复后外观良好 ,感觉恢复 ,耐磨 ,大张中厚皮片植皮是修复四肢大感染创面简单有效的方法。

Objective To observe the effect of mending an infected wound which has been enlarged and cleaned entirely by grafting a large piece of mid-thick skin on it. Methods Operations were performed on 33 cases. First their wounds were enlarged and cleaned completely,and their tendon or bones must be covered by muscular valve or fasial valve if they could be seen.Then large pieces of mid-thick skin were used to cover them.Finally they should be bound up with pressure. Results Out of the 33 cases,the survival ratio of the grafted skin was over 90% in 28 cases,which was 84.8% of all.The others' survival ratio was 60%～90%.The grafted skin on all cases healed well within two weeks.Conclusion After the skin graftings,the appearances of these wounds are fine. The sensation of the grafted skin is recovered. The grafted skin on the wounds are well wearproof. This kind of operation is a simple and effective way to mend limbs on which large wounds are seriously infected.