内置负压吸引治疗大面积皮肤脱套伤的疗效

Effect of built-in negative pressure suction in the treatment of large area skin avulsion injury

目的探讨内置负压吸引治疗大面积皮肤脱套伤的临床效果。方法对22例皮肤脱套面积10 cm×18 cm^23 cm×56 cm患者采用全厚皮片回植外置负压吸引治疗13例,采用全厚皮片回植内置负压吸引治疗9例。结果采用全厚皮片回植外置负压吸引治疗患者手术时间1~3 h,术中出血量600~1200 ml,使用负压封闭引流片3~6片;2例10%皮肤坏死,经换药后创面愈合;皮肤色泽、质地稍差,可见明显花斑样瘢痕。采用全厚皮片回植内置负压吸引治疗患者手术时间0.5~1 h,术中出血量100~400 ml,使用负压封闭引流片1~2片;经1~2次负压吸引皮肤全部成活;皮肤色泽、质地较佳,无明显瘢痕。手术时间、术中出血量、使用负压封闭引流片数量内置负压吸引明显优于外置负压吸引,差异均有统计学意义(P<0.05)。患者均获得8~12个月随访。伤口均无明显感染。结论大面积皮肤脱套伤使用全厚皮片回植内置负压吸引或外置负压吸引均可达到治疗目的,但内置负压吸引明显优于外置负压吸引。

Objective To investigate the clinical effect of built-in negative pressure suction in the treatment of large area skin avulsion injury.Methods In 22 cases,the avulsion injury area was 10 cm×18 cm^23 cm×56 cm;13 cases were treated with the external negative pressure suction treatment and the full-thickness skin flap re-plantation,and 9 cases were treated with the full-thickness skin flap re-plantation and the built-in negative pressure suction treatment.Results The patients were treated with full-thickness skin graft and external negative pressure suction within 1~3 h,the volume of intraoperative blood loss was 600~1200 ml,the number of negative pressure closed drainage tablets was 3~6;2 cases had 10%skin necrosis and the wound healed after dressing change;the skin color and texture were slightly worse and obvious scar could be seen.The operation time of the patients with built-in negative pressure suction was 0.5~1 h,and the intraoperative blood loss was 100~400 ml,the number of closed negative pressure drainage tablets was 1~2,and all the skins survived after 1~2 times negative pressure suction.Its color,texture were better,no obvious scar occurred.However,The built-in negative pressure suction was obviously better than the external negative pressure suction,the differences were statistically significant in operation time,intraoperative blood loss,the number of negative pressure closed drainage tablets(P<0.05).All patients were followed up for 8~12 months.There was no significant infection in the wound.Conclusions The built-in negative pressure suction method or the external negative pressure suction method can be used in the treatment of large area skin avulsion injury,but the built-in negative pressure suction is obviously superior to the external negative pressure suction.