湿润疗法与带真皮下血管网皮片联合治疗足顽固溃疡

MEBO in association with skin grafts of vascular net with dermis for treating refractory ulcer in foot

目的 :运用供区丰富、含真皮下血管网的全厚皮肤组织修复血运较差的足部顽固溃疡缺损。方法 :溃疡足经湿润烧伤膏 (MEBO)排除坏死组织至新鲜肉芽创面形成 ,切取腹部皮肤及皮下组织尽可能修成含脂肪少的真皮下血管网皮片 ,缝于足部损伤处打包加压。结果 :2 1例 2 7处顽固溃疡缺损足所植皮片全部成活 ,随访功能良好。结论 :经用MEBO换药治疗的创面坏死组织排除快 ,感染控制迅速 ,能使创区很快达到手术标准[1-2 ] ,含真皮下血管网游离皮片在血运差的足部可完全成活 ,与皮瓣移植修复治疗方法相比难度小 ,供区丰富 ,操作简单 。

Objective: To observe the efficacy of MEBO in association with skin graft of vascular net with dermis in treating refractory foot ulcer. Method: The wounds were treated with MEBO and necrotic tissues were removed. After granulation was formed, skin grafts of vascular net with dermis were sutured in the defect area and pressure bandaged. Result: 21 cases involving 27 ulcers and defect areas received skin grafting. All the skin grafts survived with good function after followed-up. Conclusion: Skin grafts of vascular net with dermis can survive in the area where blood circulation is poor. MEBO in association with skin graft of vascular net with dermis is very good for treating refractory foot ulcer. It is easy to operate without causing much damage.