克氏针皮肤牵张闭合器治疗肢体软组织缺损的疗效

The effect of Kirschner wire skin stretch closure device in the treatment of limb soft tissue defect

目的探讨克氏针皮肤牵张闭合器治疗肢体软组织缺损的临床疗效。方法采用克氏针皮肤牵张闭合器治疗12例软组织缺损患者。感染创面先反复清创,创面感染控制后再实施皮肤牵张术;外伤缺损创面常规一期彻底清创后进行牵张。结果患者均获得随访,时间6~23个月。2例牵张失败,经植皮或带蒂皮瓣修复后顺利愈合;1例创面缩小1/2,经植皮及换药后愈合;9例皮肤牵张到位后顺利缝合伤口并愈合。牵张成功创面皮肤呈线性愈合,瘢痕小,无血运不畅、坏死、感觉差等并发症发生。结论采用克氏针皮肤牵张闭合器治疗肢体软组织缺损供区损伤小,愈合后瘢痕小,并发症少,但应注意适应证及禁忌证。

Objective To explore the clinical effect of Kirschner wire skin stretch closure device on the soft tissue defects of limbs.Methods The 12 patients with soft tissue defects were treated with Kirschner wire skin stretch closure device.The infected wound should be firstly performed with repeated debridement,and skin stretching should be performed after complete control of wound infection.The trauma defect wound was stretched after routine complete debridement in the one-stage.Results All patients were followed up for 6~23 months.Two cases who had stretch failure healed smoothly after skin grafting or pedicle skin flap repair.In 1 case,the wound was reduced than 1/2,which healed after skin grafting and dressing change.After the skin was stretched in place in 9 patients,the wound was sutured smoothly and healed.After successful stretch,the wound skin healed linearly with small scar,and no complications such as poor blood supply,necrosis and poor sensation occurred.Conclusions In the treatment of soft tissue defects of limbs,the Kirschner wire skin stretch closure device have less donor site injury,small scar after wound healing,and few complication.It should be paid to the attention of indications and contraindication.