皮肤牵张器在下肢骨折后皮肤软组织缺损创面修复中的应用

Application of Skin Stretching Device in the Repair of Skin Soft Tissue Defects after Lower Limbs Fractures

目的:探讨皮肤牵张器在下肢骨折后皮肤软组织缺损创面修复中的应用效果。方法:选取2015年1月-2020年1月在笔者医院治疗的下肢骨折后皮肤软组织缺损患者150例,简单随机分组为观察组(n=75)和对照组(n=75)。对照组应用皮瓣修复,观察组应用皮肤牵张器的方法进行创面修复,两组患者均持续治疗直至创面愈合。比较两组患者透明质酸(Hyaluronic acid,HA)及血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平;比较两组术后并发症发生率。治疗后3个月,比较两组治疗有效率,使用温哥华瘢痕量表(Vancouver scar scale,VSS)比较两组创面愈合情况,包括创面色泽、血管分布、创面厚度和创面柔软度。结果:术后10 d,观察组患者HA水平、VECF水平显著高于对照组,差异有统计学意义(P<0.05)。两组治疗后并发症发生率比较差异无统计学意义(P>0.05)。治疗后3个月随访,观察组治疗总有效率(97.33%)显著高于对照组(88.00%),差异有统计学意义(P<0.05)。且观察组创面色泽、血管分布、创面厚度和创面柔软度评分均低于对照组,差异有统计学意义(P<0.05)。结论:下肢骨折后皮肤软组织缺损创面修复中应用皮肤牵张器治疗有良好的临床效果,可以促进缺损创面的快速愈合。

Objective To explore the application effect of skin stretching device in the repair of skin soft tissue defects after lower limbs fractures.Methods A total of 150 patients with skin soft tissue defects after lower limbs fractures treated in the hospital were enrolled between January 2015 and January 2020.They were divided into the observation group (n=75) and the control group (n=75) by simple random grouping method.The control group was given flap repair,while the observation group was given skin stretching device for wound repair.Both groups were continuously treated till wounds healing.The levels of hyaluronic acid (HA) and vascular endothelial growth factor (VEGF),incidence of postoperative complications and response rate of treatment at 3 months after surgery were compared between the two groups.The situations of wound healing (wound color,vessels distribution,wound thickness,wound softness) were compared between the two groups by Vancouver scar scale (VSS).Results After 10 d of treatment,levels of HA and VECF in the observation group were significantly higher than those in the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05).After 3 months of follow-up,the total effective rate of the observation group (97.33%) was significantly higher than that of the control group (88.00%,P<0.05).And VSS scores (wound color,vessels distribution,wound thickness,wound softness) in the observation group were lower than those in the control group (P<0.05).Conclusion The clinical application effect of skin stretching device is good in the repair of skin soft tissue defects after lower limbs fractures,which can promote rapid healing of defect wounds.