负压创面治疗技术促进皮肤移植成活的回顾性研究

Retrospective study of negative pressure wound therapy promoting survival of the skin grafts

目的观察负压创面治疗技术（negativepressurewoundtherapy，NPWT）对刃厚游离皮片移植术后皮片成活率的影响。方法对65例皮肤缺损的患者，根据皮肤移植术后皮片固定方法的不同分为两组：其中Ⅰ组为NPWT治疗组（35例），刃厚游离皮片移植术后行创面负压吸引治疗；Ⅱ组为常规治疗组（30例），刃厚游离皮片移植术后用打包或加压包扎的方式固定。结果术后第5天皮片成活率比较：Ⅰ组为（80．59±10．30）％，明显高于Ⅱ组的（71．46±10．68）％（P〈0．05）；术后皮片成活时间比较：Ⅰ组为（5．34±0．87）d，明显少于Ⅱ组的（11．20±1．65）d（P〈0．01）；术后住院治疗时间比较：Ⅰ组为（10．83±0．82）d，明显少于Ⅱ组的（15．50±1．11）d（P〈0．01）；术后抗生素费用比较：I组为（1765．71±164．39）元，明显少于Ⅱ组的（2700．00±221．28）元（P〈0．01）；术后换药次数及换药费用比较：Ⅰ组为（3．11±0．32）次、（249．14±25．82）元，明显少于Ⅱ组的（4．53±0．68）次、（362．674-54．52）元（P〈0．01）。结论刃厚游离皮片移植术后应用NPWT可以缩短皮片成活时间，缩短患者住院治疗时间，减少抗生素使用及换药次数。

Objective To observe the effects of negative pressure wound therapy （NPWT） on survival of the blade-thickness free skin grafts. Methods Sixty-five patients with skin defects were di- vided into NPWT treatment group （ Group , n = 35 ） and conventional treatment group （ Group 11 , n = 30 ） according to different postoperative fixation methods. The patients in Group Ⅰ were fixed with the aid of NPWT after blade-thickness free skin grafting, and the patients in Group Ⅱ were fixed with tie-over bolster dressing. Results The survival rate of the skin grafts of Group Ⅰ was significantly higher than that of Group Ⅱ at day 5 postoperatively [ （80.59 ± 10.30） % vs （71.46 ± 10.68 ） %, P 〈 0.05 ±. The survival period for the skin grafts of GroupⅠ was shorter than that of Group Ⅱ[ （5.34 ± 0.87 ） days vs （ 11.20 ＋ 1.65 ） days, P 〈 0. 011] The duration of postoperative hospital stay of Group I was obviously shorter than that of Group Ⅱ （P 〈0. 01 ）. The cost of antibiotics of Group I was less than that of Group Ⅱ[ （ 1 765.71 ＋ 164.39） RMB yuan vs （2 700.00 ±221.28） RMB yuan, P 〈0.01 ]. The dressing frequency and cost of group Ⅰwere less than those of group Ⅱ ± （3. 11 ± 0. 32） times, （249. 14 ±25.82） RMB yuan vs （4.53 ±0.68） times,（362.67 ±54.52） RMB yuan, P〈0.01]. Conclusions The application of NPWT to the postoperative period of skin grafting can promote the survival of the skin grafts, shorten the duration of hospitalization and reduce antibiotics use and dressing frequency.