自主设计创面测量膜在全厚皮片游离移植治疗四肢皮肤软组织缺损中的应用

Application of self-designed wound measuring membrane in the treatment of limb skin and soft tissue defects with full-thickness skin graft

目的探讨自主设计创面测量膜在全厚皮片游离移植治疗四肢皮肤软组织缺损中的临床治疗效果。方法自2018年1月至2020年6月对13例四肢皮肤软组织缺损创面应用全厚皮片游离植皮修复的患者,术中采用自主设计的创面测量膜测量创面大小,根据测量结果在供区切取全厚皮片,供区直接闭合。术后定期随访受区及供区伤口愈合情况、植皮成活情况及四肢功能恢复状况等。结果13例植皮皮肤全部成活,所有伤口术后均未出现感染,伤口Ⅰ期愈合。术后随访3~15个月,平均8.6个月,植皮皮肤外观良好,植皮处皮肤高度与周围组织较为一致,供区存留线状瘢痕,四肢功能恢复良好。结论全厚皮片游离移植治疗四肢皮肤软组织缺损创面,术中应用自主设计创面测量膜对创面进行测量和手术设计,能提高游离皮肤利用率,减少供区损伤,缩短手术时间,提高手术效率,临床效果好,具有推广价值。

Objective To explore the clinical efficacy of self-designed wound measurement membrane in the treatment of limb skin and soft tissue defects with full-thickness skin graft.Methods From January 2018 to June 2020,13 patients with limb skin and soft tissue defects were treated with full-thickness skin graft.During the operation,the wound size was measured with self-designed wound measurement membrane.According to the measurement results,the full-thickness skin graft was cut from the donor area,and the donor area was closed directly.The wound healing,skin graft survival and limb function recovery in the recipient and donor areas were followed up regularly after operation.Results All the 13 cases of skin grafting survived,all the wounds had no infection after operation,and the wounds achieved primary healing.The postoperative follow-up ranged from 3 to 15 months,with an average of 8.6 months.The appearance of the skin graft was good,the height of the skin at the graft was consistent with the surrounding tissue,there were linear scars in the donor area,and the function of the limbs recovered well.Conclusion The application of self-designed wound measuring membrane to measure and design the operation of full-thickness skin graft in the treatment of limb skin and soft tissue defects can improve the utilization rate of free skin,reduce the damage of donor area,shorten the operation time and improve the operation efficiency.The clinical effect is good and has the value of popularization.