一期带蒂网状全厚皮片回植联合负压封闭引流治疗四肢皮肤脱套伤

Treatment of extremities degloving injury with pedicle mesh full-thickness skin graft combined with VSD at the single stage

目的探讨应用一期带蒂网状全厚皮片回植联合负压封闭引流(VSD)治疗四肢皮肤脱套伤效果。方法对58例四肢皮肤脱套伤患者采用一期带蒂网状全厚皮片回植联合VSD治疗。结果 52例脱套皮肤一期成活;5例皮肤部分成活,清创后再次游离全厚皮片移植成活;1例合并严重感染及组织缺血坏死予以截肢。57例获得随访,时间3～6个月,成活皮片功能均恢复良好。结论一期带蒂网状全厚皮片回植联合VSD治疗四肢皮肤脱套伤能起到控制感染及促进植皮成活的效果。

Objective To investigate the effect of the single stage pedicle mesh full-thickness skin graft combined with VSD in the treatment of extremities degloving injuries. Methods The 58 cases with extremities degloving injuries were treated with the single stage pedicle mesh full-thickness skin graft combined with VSD. Results The 52 cases of skin grafts were full alive; skin grafts in 5 cases were survived mostly,which were survived by free full-thickness skin grafting treatment after debridement; 1 case with serious infection and tissue necrosis was amputated. The 57 patients were followed up for 3 ～ 6 months. The function of the survival skin graft was good. Conclusions The single stage pedicle mesh full-thickness skin graft combined with VSD in treating extremities degloving injury play infection control for the effect of skin graft survival.