皮瓣移植对四肢软组织缺损的疗效及预防感染分析

Analysis of efficacy and prevention of infections of flaps transplantation on soft tissue defects of limbs

目的探讨皮瓣移植对四肢软组织缺损的疗效,降低损伤的感染率。方法选择2009年3月-2012年3月医院接诊的90例四肢软组织缺损的患者进行研究,按照随机数表法分为A、B、C 3组,每组各30例患者,A组患者采用游离股前外侧穿支皮瓣进行手术治疗,B组采用传统的整张植皮对患者进行治疗,C组患者采用邮票状植皮术对患者进行治疗。结果 A组患者感染发生率6.7%明显低于B组的33.3%和C组的43.3%;A组患者皮肤温度升高、皮肤红肿、皮肤感染坏死的发生率分别为3.3%、3.3%、0,B组分别为23.3%、6.7%、3.3%,C组分别为26.7%、10.0%、6.7%,A组与B、C组发生率比较差异有统计学意义(P<0.05);A组患者的术后两点感觉长度为(6.1±0.3)mm明显短于B组的(8.6±0.5)mm及C组(9.1±0.3)mm;A组患者治疗的临床有效率为100.0%明显高于B组的73.3%和C组的70.0%。结论游离股前外侧穿支皮瓣对四肢软组织缺损的疗效显著,提高了临床疗效,降低了感染发生率。

OBJECTIVE To explore the efficacy of flaps transplantation to the soft tissue defects of the limbs, so as to reduce the infection rate of injury. METHODS A total of 90 patients with the limbs soft tissue defects were selected for the study admitted in our hospital from Mar. 2009 to Mar. 2012. The patients were divided into 3 groups of A, B, C according to the random number table method, with 30 patients in each group. The free anterolateral thigh perforating branch flap surgery was performed on the patients in group A, and patients in group B were treated with traditional whole skin graft, the patients in group C were treated with stamp-like skin grafting. RESULTS Group A patients were with elevated skin temperature, skin irritation, infection and necrosis, with the incidence of 3.3%,3.3 %,0. By comparing the infection rate in group A with group B （23.3 %, 6.7% and 3.3%）, C（26.7%, 10.0% and 6.7%）, the difference was statistically significant （P〈0.05）. Two points feel length in patients of group A （6. lxk0.3mm） was significantly shorter than that in group B （8.6±0.5 mm ） and group C （9.1±0.3mm）. The clinical efficiency of the treatment of the patients in group A （100.0%） was significantly higher than that in group B （73.3%） and group C（70.0%）. The incidence of infection in group A （6.7 %） was significantly lower than that in group B （33.3 %） and group C （43.3 % ）. CONCLUSION The efficacy of free anterolateral thigh perforating branch flap on the soft tissue defects of the limbs is significant and can improve the clinical efficacy of the treatment and reduce the infection rate.