应用皮肤牵张技术闭合四肢创面的临床观察

Clinical observation of wound closure of limbs with skin stretch technique

[目的]观察皮肤牵张技术在闭合四肢创面皮肤软组织缺损的效果。[方法]回顾性对比分析2016年4月～2017年3月31例四肢创面缺损患者资料,其中牵张器组15例采用皮肤牵张器治疗,非皮肤牵张器组16例采用传统方法 (非皮肤牵张器技术)治疗。比较两组患者住院天数、术后伤口感染例数、创面手术次数及患者满意度。[结果]牵张器组住院天数少于非皮肤牵张器组,差异有统计学意义(t=-3.203,P=0.003);术后牵张器组有1例出现感染,非皮肤牵张器组出现1例感染,两组间差异无统计学意义(x^2=0.002,P=0.962);牵张器组创面手术次数与非皮肤牵张器组比较,差异无统计学意义(t=-1.168,P=0.252);牵张器组患者满意度高于非皮肤牵引器组,差异有统计学意义(x^2=11.675,P=0.020)。[结论]与非皮肤牵张器组相比,应用皮肤牵张器治疗四肢创面皮肤缺损能够缩短住院天数,提高患者满意度。

[Objective] To observe the outcomes of skin stretch technique on closing skin and soft tissue defects on the limbs. [Methods] A retrospective study was conducted on 31 patients with skin and soft tissue defects on the limbs from April2016 to March 2017. Among them, 15 patients had the defect closed with skin stretchers（the stretch group）, whereas the remaining 16 patients underwent the traditional methods for closing the defect（the non-stretch group）. The days of hospitalization, the number of wound infection, the number of wound operations and patient satisfaction were compared between the two groups. [Results] The hospital stay after surgical treatment in the stretch group was considerably less than that in the nonstretch group（t=-3.203, P=0.003）. Both the stretch group and non-stretch group had 1 case of wound infections after operation without a statistical difference between the two groups（χ^2=0.002, P=0.962）. Although the number of surgical intervention to the wounds was not statistically different between the stretch group and the non-stretch group（t=-1.168, P=0.252）, the patients self-satisfaction in the former group was significant greater than that of the latter group（χ^2=11.675, P=0.020）. [Conclusion]Compared to the non-skin stretch technique, the skin stretcher for closing skin and soft tissue defect on the limbs does shorten hospital stay and improve patients self-satisfaction.