穿支皮瓣修复对手外伤软组织缺损患者创面愈合及炎性反应的影响

Effects of Perforator Flaps Repair on Wound Healing and Inflammatory Response in Patients with Hand-traumatic Soft Tissue Defects

目的:观察穿支皮瓣修复对手外伤软组织缺损患者创面愈合及炎性反应的影响。方法:选择2018年2月-2020年2月本院收治的84例手外伤软组织缺损患者,依据随机数字表法将其分为对照组和观察组,各42例。对照组采用胸腹带蒂皮瓣修复术治疗,观察组采用穿支皮瓣修复术治疗。对比两组临床疗效、创面愈合时间、压觉、炎性反应[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)]及并发症发生情况。结果:观察组治疗优良率(90.48%)高于对照组(73.81%);创面愈合时间为(5.71±1.48)d,早于对照组;压觉为(0.39±0.13)g,低于对照组,差异有统计学意义(P<0.05)。术前两组TNF-α、IL-6水平对比,差异无统计学意义(P>0.05);术后观察组TNF-α与IL-6水平分别为(0.23±0.06)、(0.87±0.26)ng/ml,均低于对照组,差异有统计学意义(P<0.05);两组并发症发生率相比,差异无统计学意义(P>0.05)。结论:穿支皮瓣修复术用于手外伤软组织缺损治疗中有利于恢复患者手部外观及功能,控制炎性反应,促进创面愈合,有利于提升手外伤软组织缺损修复效果。

Objective:To observe the effect of perforator flaps repair on wound healing and inflammatory response in patients with hand-traumatic soft tissue defects.Method:Eighty-four patients with hand-traumatic soft tissue defects admitted to our hospital from February 2018 to February 2020 were selected and divided into the control group and the observation group according to the random number table method,each with 42 cases.The control group was treated with thoracic and abdominal pedicle flap repair,and the observation group was treated with perforator flap repair.The clinical efficacy,wound healing time,pressure sensation value,inflammatory response[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]and complications were compared between the two groups.Result:The excellent and good rate of treatment in the observation group(90.48%)was higher than 73.81% in the control group,the wound healing time in the observation group was(5.71±1.48)d,which was earlier than that in the control group,and the pressure sensation in the observation group was(0.39±0.13)g,which was lower than that in the control group,the differences were statisticallysignificant(P<0.05).Before operation,the levels of TNF-α and IL-6 in the two groups were not statistically significant(P>0.05).After operation,the levels of TNF-α and IL-6 in the observation group were(0.23±0.06),(0.87±0.26)ng/ml,which were lower than those in the control group,the differences were statistically significant(P<0.05).Compared with the incidence of complications between the two groups,the difference was not statistically significant(P>0.05).Conclusion:Perforator flap repair for the treatment of hand-traumatic soft tissue defects is conducive to restoring the appearance and function of patients’hands,controlling inflammatory response,promoting wound healing,and improving the repair effect of hand-traumatic soft tissue defects.