负压封闭引流技术在小腿带蒂岛状皮瓣供区植皮中的应用

Application of vacuum sealing drainage in skin graft of calf pedicle island flap donor-site

目的:探讨负压封闭引流技术在小腿带蒂岛状皮瓣供区创面游离植皮的临床疗效。方法:选取在本院行小腿带蒂岛状皮瓣修复足踝部及小腿部皮肤软组织缺损患者共70例,按手术先后顺序随机分为VSD组和压包组。VSD组供区皮瓣切取后予游离植皮及负压封闭引流术;压包组供区皮瓣切取后予游离植皮及传统植皮压包术。观察记录两组术后第1天、第7天、第14天视觉疼痛模拟评分(VAS),并观察比较两组拆包时间、植皮愈合时间、植皮存活率、感染率和皮下血肿发生率。结果:VSD组术后第7天、第14天VAS评分均低于压包组(P<0.05);VSD组拆包时间及植皮愈合时间均短于压包组(P<0.05);VSD组植皮存活率高于压包组(P<0.05);VSD组感染率和皮下血肿发生率均低于压包组(P<0.05)。结论:负压封闭引流技术有利于促进小腿带蒂岛状皮瓣供区创面游离植皮的愈合,缓解疼痛,减少不良反应,安全有效,值得临床推广。

Objective：To explore the clinical effect of vacuum sealing drainage on free dermatoplasty in the donor-site of calf pedicled island flap.Methods：From January 2016 to January 2018,a total of 70 patients undergoing reconstruction of skin and soft tissue defects in ankles and legs with calf pedicle island flap in Foshan Traditional Chinese Medicine Hospital were selected into our research.Selected patients were divided into VSD group and pressure dressing group according to the order of surgery.The VSD group was treated with free skin grafting and vacuum sealing drainage after separation of donor-site flap.The pressure dressing group was treated with free skin grafting and traditional pressure dressing technology after the separation of donor-site flap.Visual acuity simulation scores（VAS）were observed and recorded on the 1st,7th,and 14th day after surgery.The unpacking time,skin graft healing time,skin graft survival rate,infection rate and incidence of subcutaneous hematoma were compared between the two groups.Results：The VAS scores on the 7th and 14th day after surgery in the VSD group were lower than those in the pressure dressing group（P〈0.05）.The unpacking time and skin graft healing time of the VSD group were shorter than those of the pressure dressing group（P〈0.05）.The survival rate of skin graft in VSD group was higher than that in the pressure dressing group（P〈0.05）.The infection rate and the incidence of subcutaneous hematoma in the VSD group were lower than those in the pressure dressing group（P〈0.05）.Conclusion：Vacuum sealing drainage is beneficial to promote the healing of free skin grafts in the donor site of the calf pedicle island flap,relieve pain and reduce adverse reactions.It is safe,effective,and worthy of clinical promotion.