负压创面治疗技术在撕脱伤创面皮片移植中的应用

Application of skin transplantation assisted with vacuum assisted closure in the treatment of the wound after avulsion injury

目的 探讨应用封闭负压引流辅助皮片移植治疗撕脱伤创面的效果.方法 对18例撕脱伤所致皮肤软组织缺损患者术后常规换药或采用封闭负压引流技术治疗,待创面形成新鲜肉芽组织后行植皮术.术中将所取断层皮片打孔后移植于创面,予以网眼纱布覆盖,采用封闭负压引流技术代替传统的敷料包扎,1周后移除封闭负压引流敷料,查看皮片的成活情况.结果 所有患者经1次清创手术和1-3次植皮手术.术后皮片绝大部分成活,有5例患者出现移植皮片边缘部分坏死,经换药后愈合.结论 对较大面积撕脱伤创面应用封闭负压引流治疗辅助皮片移植能取得很好的效果.但皮片打孔对成活后的外观有一定影响.

Objective To explore the effect of skin transplantation assisted with vacuum assisted closure on the treatment of wound ＂after avulsiou injury. Methods Eighteen patients with avulsion injury were treated with regular dressing change or vacuum assisted closure after operation, skin graft was carried out until fresh granular tissue formed in the wound. The harvested split-thickness skin graft was transplanted to the wound after perfaration and the wound was covered with mesh gauze and packed assisted by vacuum assisted closure instead of traditional dressing bandage. The vacuum assisted closure was removed at one week and the survival of skin graft was observed. Results Each patient underwent one time debridement and 1 to 3 times skin grafting assisted by vacuum assisted closure. All the flaps survived well except for 5 cases with necrosis of the margin of grafts which healed after dressing change. Conclusion For the large wound after avulsiou injury, especially the wound located in the buttock and perineum, the skin graft assisted by vacuum assisted closure can achieve good results. However, the perforated flap may have some effect on the postoperative survival.