皮肤牵张闭合器在糖尿病足创面修复中的应用

Application of skin stretching device in repair of diabetic foot wound

目的探讨皮肤牵张闭合器在糖尿病足创面修复中的临床应用价值。方法回顾分析2015年10月—2016年7月,采用皮肤牵张闭合器治疗的24例糖尿病足患者(试验组)临床资料,与同期采用封闭式负压引流联合植皮修复的24例患者(对照组)进行比较。两组患者性别、年龄、侧别、病程、TEXAS分级分期等一般资料比较,差异均无统计学意义(P>0.05)。两组患者均根据细菌培养结果,同时应用敏感抗生素治疗。结果术后试验组及对照组各1例发生感染,均经对症处理后创面愈合。其余患者创面均顺利愈合,其中试验组愈合时间为(12.8±11.6)d,较对照组(22.3±10.4)d显著缩短,比较差异有统计学意义(t=2.987,P=0.005)。两组患者术后均获随访,随访时间3～12个月,创面无裂开,随访期间溃疡无复发。结论与封闭式负压引流联合植皮修复相比,应用皮肤牵张闭合器治疗糖尿病足创面更简便,能缩短创面愈合时间,且创面愈合外观后与邻近皮肤相似。

Objective To evaluate the clinical value of skin stretching device in repair of diabetic foot wound.Methods A retrospective analysis was made on the clinical data of 48 cases with diabetic foot wound who were treated with skin stretching device（trial group, n=24） and with the vacuum sealing drainage combined with skin graft（control group, n=24） respectively between October 2015 and July 2016. There was no significant difference in gender, age, side,course of disease, TEXAS stage between 2 groups（P〈0.05）. Both patients in 2 groups were treated with sensitive antibiotics according to the results of bacterial culture. Results One case in control group was infected and the skin graft failed, and 1 case in trial group was infected after the treatment, and the two wounds healed after symptomatic treatment.The wounds of the other patients healed successfully, and the healing time of the trial group was significantly shorter than that of the control group [（12.8±11.6） days vs.（22.3±10.4） days; t=2.987, P=0.005）. All patients were followed up 3-12 months after operation, and no wound dehiscence or recurrence occurred during follow-up. Conclusion Compared with the vacuum sealing drainage combined with skin graft, the application of skin stretching device in the repair of diabetic foot wound has advantages, such as easy to operate, shorten the wound healing time, and the appearance of wound was similar with the adjacent skin.