“迷你”负压引流在前臂游离皮瓣移植供区缺损修复中的应用

Application of the mini vacuum drainage ball in repair of donor site defect after forearm free flap harvest

目的:探讨"迷你"负压引流在前臂游离皮瓣移植供区缺损修复中的应用效果。方法:选择口腔颌面部恶性肿瘤患者44例,均接受前臂游离皮瓣移植同期修复肿瘤切除术后缺损,采用腹部全厚皮片修复前臂供区缺损,分别应用"迷你"负压引流法(22例)和传统加压法(22例)。观察评估术后前臂区域引流量、移植皮片愈合情况和患者主观满意程度,采用SAS 9.4软件包对数据进行统计学分析。结果:"迷你"负压引流组22例患者中,20例皮片完全成活,创面平整,愈合良好,无结痂、渗出及感染;2例皮片边缘部分坏死,简单清理换药后痊愈。传统加压组22例患者中,18例皮片完全成活,4例出现部分坏死。术后随访6~10个月,"迷你"负压引流组皮片颜色接近正常皮色,手部运动、感觉功能正常,患者主观满意度显著高于传统加压组(P<0.05)。结论:"迷你"负压引流应用于前臂皮瓣制备后缺损的植皮修复,安全有效,成本低廉,患者满意舒适度高,值得临床推广应用。

PURPOSE:To evaluate the efficacy of mini vacuum drainage in repair of donor site defect after forearm free flap harvest.METHODS:Free forearm skin flaps were applied for repairing defects after tumor resection in 44 patients with oral and maxillofacial carcinoma.Full thickness abdominal flaps were used to repair the donor site defects with mini vacuum drainage(experimental group,n=22)and traditional compression(control group,n=22),respectively.The total drainage in forearm area,healing condition of transplanted flaps and patients’satisfaction were observed after operation.SAS 9.4 software package was used for data analysis.RESULTS:In the experimental group,20 flaps survived completely with smooth wounds and good healing,meanwhile without scab,exudation and infection.Partial necrosis of the other two flaps occurred on the edge.After simple cleaning and changing dressing,the flaps recovered.All patients were followed up for 6-10 months.In the experimental group,the color of the flaps was closer to the normal skin,the motor and sensory function of hand were normal,while the patients’satisfaction was higher than the control group(P<0.05).CONCLUSIONS:The mini vacuum drainage is safe,effective and low cost for repairing donor site defect after forearm free flap harvest with high patients’satisfaction,it is worth to use and spread.