托氏皮肤牵张闭合器闭合创面用于四肢软组织缺损的效果及安全性

Effectiveness and safety of closure of wounds with Tolstoy’s skin retractor closure for soft tissue defects of limbs

目的研究托氏皮肤牵张闭合器闭合创面用于四肢软组织缺损的效果及安全性。方法纳入2018年6月至2021年6月解放军海军第九七一医院收治的80例四肢软组织缺损的患者为研究对象,按照随机数学表法分为两组,各40例。其中对照组创面负压吸引后行皮瓣修复,观察组使用托氏皮肤牵张闭合器闭合创面。观察两组一期愈合情况及平均愈合时间,并比较两组住院时间、住院费用、换药费用情况。分析两组缺损部位感觉功能恢复情况及两组治疗效果,比较两组并发症发生情况。结果观察组一期愈合率高于对照组(P<0.05)。所有一期未愈合患者均通过二期手术修复。观察组浅Ⅱ度和深Ⅱ度创面平均愈合时间及住院时间短于对照组,住院费用低于对照组,差异有统计学意义(P<0.05)。观察组缺损部位感觉功能恢复情况优于对照组,差异有统计学意义(P<0.05)。观察组治疗效果优于对照组,差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论托氏皮肤牵张闭合器用于四肢软组织缺损可有效促进缺损组织修复,缩短创面愈合时间,并发症发生风险较小,安全性较好,值得临床推广。

Objective To study the effectiveness and safety of the Tolstoy’s skin retracor closure for soft tissue defects of the extremities.Methods Eighty patients with soft tissue defects of the extremities admitted to the 971st Naval Hospital of Chinese People’s Liberation Army from June 2018 to June 2021 were included in the study,and were divided into two groups of 40 cases each group,according to the random number table method.In the control group,flap repair was performed after negative pressure suction of the trauma.In the observation group,the trauma was closed with a torso skin retraction closure.The first-stage healing and the average healing time in the two groups were observed,and the hospitalization time,hospitalization cost,and drug exchange cost between the two groups were compared.The recovery of sensory function at the defect site and the treatment efficacy of the two groups were analyzed,and the occurrence of complications in the two groups were compared.Results The one-stage healing rate was higher in the observation group than in the control group(P<0.05).All patients with non-healing stageⅠwere repaired by stageⅡsurgery.The mean healing time and hospitalization time of superficialⅡdegree and deepⅡdegree wounds in the observation group were shorter than those in the control group,and the hospitalization cost was lower than that in the control group,with statistically significant differences(P<0.05).The recovery of sensory function at the defect site was better in the observation group than in the control group,and the difference was statistically significant(P<0.05).The treatment effect of the observation group was better than that of the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The use of Tolstoy’s skin retraction closure device for soft tissue defects of the extremities can effectively promote defective tissue repair,shorten wound healing time,with less risk of complications and better safety,and is worthy of clinical promotion.