皮肤原位回植联合封闭式负压引流技术治疗手部皮肤撕脱伤

Skin in situ replantation and vaccum sealing drainage to treat hand skin avulsion

目的总结撕脱皮肤修薄后原位回植联合封闭式负压引流技术（vacuum sealing drainage，VSD）修复手背部皮肤撕脱伤的临床效果。方法2008年1月-2011年12月，采用撕脱皮肤修薄后成全厚皮片原位回植联合封闭式负压引流技术一期修复手背部皮肤撕脱伤18例。结果本组18例撕脱皮肤全部成活，其中2例撕脱皮肤远端皮缘部分坏死，经换药后创面愈合。术后18例均获随访，随访时间3-12个月，平均9个月，创面外观颜色略暗红．弹性好，关节功能基本恢复正常。结论皮肤原位回植联合VSD技术可为组织修复提供密封环境．引流充分，加压均匀，降低了组织感染坏死的几率．增加撕脱皮肤成活的机会，有效地促进了患手外观和功能的恢复。

Objective To summarize the clinical effects of using vaccum sealing drainage （VSD） technology combined with in situ replantation to repair hand back skin avulsion. Methods From January 2008 to December 2011, we used vaccum sealing drainage （VSD） technology combined with in thin repairing skin avulsion to full-thickness skin to in situ graft on the first stage. Results Avulsion skin basically in 16 cases survived after 8 to 10 days＂ treatment, distal skin edge of avulsion skin in 2 cases partly mortified, and the wound healed after changing dressing. 18 cases were all followed up for 3 to 12 months after treatment, with an average of 9 months. After replantation, the color of skin graft wound appeared slightly dark red, with good elasticity, joint function returned basically to normal. Conclusion It can provide a sealed environment for skin replantation with full drainage and uniform pressure by using VSD technology and in situ replantation for repairing hand back skin avulsion, and play an important role to reduce the probability of tissue infected necrosis, improve the chances of survival of skin avulsion, and effectively guarantee the appearance and function of the hand.