挛缩性瘢痕松解术联合自制负压引流装置的应用探讨

Application of Contracture Scar Release Combined with Self-made Negative Pressure Drainage Device

目的:探讨挛缩性瘢痕松解术联合自制负压引流装置的疗效。方法:选取笔者医院2016年1月-2018年10月收治的35例挛缩性瘢痕患者为治疗组,行挛缩性瘢痕松解+Z成形,随后予自制负压引流装置,另选取2013年1月-2015年12月收治的35例挛缩性瘢痕患者为对照组,缩性瘢痕松解+Z成形后仅予无菌敷料包扎。两组患者均连续观察21d,比较其瘢痕边缘坏死与创面感染的发生情况、换药疼痛程度、功能评价、创面愈合时间及住院时间等。结果:治疗组并发症发生率为5.7%低于对照组的14.3%,差异有统计学意义(P<0.05)。治疗组治疗后前4次换药疼痛评分均低于对照组,差异有统计学意义(P<0.05)。治疗组的功能评价总有效率为94.3%高于对照组的71.4%,差异有统计学意义(P<0.05)。治疗组的创面愈合时间与住院时间均少于对照组,差异有统计学意义(P<0.05)。结论:挛缩性瘢痕松解术联合自制负压引流装置能使瘢痕瓣更好成活,减少皮缘坏死,提高愈合质量,更符合瘢痕防治动态综合疗法。

Objective To investigate the efficacy of contracture scar release combined with self-made negative pressure drainage device.Methods Thirty-five patients with contracture scars admitted to our hospital from January2016to October2018were selected as the study subjects.The patients in the treatment group were treated with Z-plasty and vacuum drainage device.Another35patients with contracture scars admitted to our hospital from January2013to December2015were selected as the control subjects.The control group was treated with sterile dressing.The incidence of scar marginal necrosis and wound infection,dressing change pain,functional evaluation,wound healing time,hospitalization time and hospitalization cost were compared between the two groups.Results The incidence of complications in the treatment group was5.7%lower than that in the control group(14.3%),the difference was statistically significant(P<0.05).After treatment,the pain score of the treatment group was lower than that of the control group(P<0.05).The total effective rate of functional evaluation in the treatment group was94.3%higher than that in the control group(71.4%,P<0.05).The wound healing time and hospitalization time in the treatment group were less than those in the control group(P<0.05).Conclusion Contracture scar lysis combined with self-made negative pressure drainage device can make the scar flap survive better,reduce skin necrosis,improve the quality of healing,more in line with the dynamic comprehensive therapy of scar prevention and treatment.