大张次全厚皮肤移植和封闭负压引流修复足部严重碾压伤18例

Repair of severe feet mangled injury with large subtotal thickness skin graft and vacuum sealing drainage in 18 cases

目的:观察应用大张次全厚皮肤移植和负压封闭引流技术(VSD)修复足部严重碾压伤的临床效果。方法:18例严重足部碾压伤患者于伤后早期予以彻底清创,创面采取VSD治疗,待创面肉芽组织生长良好后,腹部取皮,制成大张次全厚皮肤进行创面移植,再此采用VSD方法固定包扎术区。结果:18例患者皮片均成活良好,患足外形满意,能够较为自如地着地行走,患者满意。结论:次全厚皮肤移植联合VSD技术能够较好地修复严重足部碾压毁损伤,皮片成活率高,足部外形满意,在基层医院易于开展。

Objective:To observe the clinical efficacy of large subtotal thickness skin grafting and vacuum sealing drainage(VSD)in the treatment of severe mangled injury of feet.Methods:Eighteen wounded persons with severe feet mangled injury received completely debridement at the early stage after injury,and then were treated with VSD.After the granulation tissue grew well,wounds were covered with large subtotal thickness skin taken and prepared from the skin of abdomen area,and then fixed and bound up with VSD.Results:The grafting skins in all the 18 cases survived well,the appearance of feet was satisfying.Patients could walk freely and satisfied with the curative effects.Conclusions:Subtotal thickness skin transplantation combined with VSD can repair the serious foot mangled injury with satisfying effect,the grafting skins have higher survival rate and make a better prepared shape of the wounded foot.Moreover,the surgery is easy to operate in a grass-roots hospital.