皮能快愈敷料在蛇伤性肢体溃疡中的临床应用

Clinical application of Pelnac in snake wound of limbs ulcer

目的探讨应用皮能快愈敷料(皮耐克)加自体刃厚皮片复合移植修复蛇伤性肢体溃疡的治疗效果。方法回顾性分析我院2004年4月至2011年11月42例蛇伤性肢体溃疡患者的治疗方法。A组24例,早期清创,予抗感染,改善微循环,感染控制后行植皮或皮瓣修复术;B组16例,予抗感染,改善微循环,早期清创,感染控制后外敷皮能快愈敷料(皮耐克),诱导真皮重建,促进肉芽组织生长,待其肉芽生长满意后行植皮术。结果 A组患者供皮区有不同程度的疤痕及色素改变,肢体部分功能障碍,住院时间长,费用高;B组患者供皮区有不同程度色素沉着,无明显疤痕,肢体功能恢复好。结论皮耐克与自体刃厚皮片复合移植治疗蛇伤性肢体溃疡,既有利于创面愈合,又对供皮区影响小,并降低肢体致残率,是一种较好的治疗方法。

Objective To explore the clinical application of cpelnac composite of sell thickness skin piece to repair the snake wound of limbs ulcer. Methods Retrospectively analyzed the treatment of 42 patients with the snake wound ulcer of limb in April 2004 to November 2011. There are 24 cases in a groups, accepted early debridement, gives anti - infection, improver microcirculation, the skins or flap prosthesis after infection controlled. Group B of 16 cases, accepted infection, improved microcirculation, early debridement, promoted the growth of granulation tissue, and waited for the granulation growth satisfied to carry out the skin grafting. Results Patients in group A for skin area had different degrees of scar and pigment changed, body function had obstacle, length of hospital stay long, high cost. Group B patients for skin area had different degree pigmentation, had not obvious scar, limb function recovered well. Conclusions Pelnae composite of self thickness skin piece to repair the snake wound of limbs ulcer can promote wound healing, reduce damage of supply skin area, and reduce physical disability rate; is a kind of good treatment.