创面愈合技术联合整形手术治疗胸壁结核性创面的临床疗效

Clinical efficacy of plastic surgery and wound healing to repair the wounds of chest wall tuberculosis

目的探索采用创面愈合技术（病灶清创＋负压封闭引流）联合整形手术（皮瓣转移、植皮、皮瓣填塞等）治疗复杂性胸壁结核创面的有效性和可行性。方法收集住院胸壁结核创面患者共11例，对治疗效果、术中、术后并发症及随访情况进行回顾性分析。结果创面愈合技术联合整形手术治疗7例，治愈6例，有效率达90．9％；创面清创＋整形手术治疗4例，治愈4例；ll例患者，1例术后复发，其余10例随访3～34个月，无1例复发。结论创面愈合技术联合整形手术是治疗胸壁结核性创面的一种有效方法，对病灶浸润较深的胸壁结核性创面有较好治疗效果。

Objective To treat complex wounds of the chest wall tuberculosis by the use of wound healing techniques （focal debridement ＋ the VSD） and joint plastic surgery （transfer of skin flap, skin graft, flap stuffing, ere） and to explore the clinical features of the tuberculous chest wound, the feasibility and effectiveness of treatments. Methods Clinical data of 11 hospitalized patients with chest wall tuberculosis were collected during 2012-2014. The therapeutic effect, intraoperative and postoperative complications, and postoperative follow-up were retrospectively analyzed. Results Among 7 cases using lesion debridement, VSD suction drainage and local flap repair （skin grafting）, 6 cases were cured. The response rate was 90.9%. All 4 cases using debridement and local flap repair （skin grafting） were cured. Only one case of recurrence was observed during the follow-up period of 3- 34 months. Conclusions Using of wound healing techniques with plastic surgery is an effective treatment, which has good therapeutic effect on the wound deeply infiltrated.