Top-closure皮肤牵张器结合伤口床准备治疗感染性皮肤软组织缺损的疗效研究

Study on Curative Effect of Top-Closure Skin Distractor Combined with Wound Bed Preparation in the Treatment of Infectious Skin and Soft Tissue Defects

目的探讨Top-closure皮肤牵张器结合伤口床准备治疗感染性皮肤软组织缺损的疗效。方法根据纳入和排除标准纳入皮肤软组织缺损伴感染的患者18例,皮肤软组织缺损面积为4.71~98.96 cm^(2),根据病情需要给予纠正营养、控制血糖等基础治疗,伤口做细菌培养及药敏实验,再根据细菌培养及药敏结果给予敏感抗生素治疗,同时给予TIME原则伤口床准备及Top-closure皮肤牵张器做皮肤牵张。结果18例患者中痊愈17例,有效1例,好转及无效0例,痊愈时间20~66 d,平均(33.22±10.81)d,有效的1例患者牵张及伤口床准备10 d后给予游离植皮,创面完全愈合时间为23 d。17例皮肤牵张痊愈的患者,伤口呈线性瘢痕愈合,愈合创面的皮肤的感觉、色泽、伸缩弹性和正常皮肤无明显差异。结论Top-closure皮肤牵张系统结合伤口床准备的精细化管理对感染性皮肤软组织缺损能起到很好的治疗效果。

Objective To investigate the curative effect of Top-closure skin distractor combined with wound bed preparation in the treatment of infectious skin and soft tissue defects.Methods According to the inclusion and exclusion criteria,18 patients with skin and soft tissue defects with infection were included.The area of skin and soft tissue defects was 4.71~98.96 cm^(2).According to the condition of the disease,the patients were given basic treatment such as nutrition correction and blood sugar control.Bacterial culture and drug sensitivity test were performed on the wound,and sensitive antibiotics were given according to the results of bacterial culture and drug sensitivity.At the same time,the TIME principle wound bed preparation was induced and top-closure skin distractor were given for skin stretch.Results Among the 18 patients,17 cases were cured,1 case effective,and 0 case was improved or ineffective.The recovery time ranged from 20 days to 66 days,with an average of(33.22±10.81)days.The patient with effective treatment result was given free skin grafting after 10 days of stretching and wound bed preparation,and the wound healing time was 23 days.The wounds of 17 patients healed by skin stretch showed linear scar healing,and there was no significant difference in the sensation,color,elasticity between the healed skin and the normal skin.Conclusion Top-closure skin traction system combined with meticulous management of wound bed preparation achieves a very good therapeutic effect on infected skin and soft tissue defects.