功能部位皮肤软组织缺损创面治疗的新选择  

A new choice to treat skin and soft tissues defected wounds of functional part

作　　者：刘飞[1] 张陈威[1] 郭正东[1] 林海波[1] 洪浩[1] 杨卫国[1] 梁智[1] 

机构地区：[1]广东医学院附属深圳南山医院整形美容科,广东深圳518052

出　　处：《中国美容医学》2013年第1期108-111,共4页Chinese Journal of Aesthetic Medicine

基　　金：2012深圳市科技计划项目(编号:201203226)

摘　　要：目的:总结封闭式负压引流(vacuum-assi st ed cl osure,VAC)技术联合人工真皮(PELNAC)治疗功能部位皮肤软组织缺损创面的良好效果,推广该治疗方法的临床应用。方法:2008年3月～2011年12月,笔者应用VAC联合PELNAC治疗11例患者13处创面,其中车祸伤9例、自行车辐条搅伤1例、过山车滚轮碾压伤1例,所有创面均位于下肢,均为关节功能部位创面,9例有深部组织外露,伴有不同程度的关节功能障碍。围手术期行全身支持治疗,尽快扩创,行VAC治疗,创面肉芽组织生长新鲜后行PELNAC移植,PELNAC血管化后,行自体刃厚皮片移植。结果:所有创面经VAC治疗后,肉芽组织生长迅速,部分或完全覆盖深部外露组织,行PELNAC加自体刃厚皮片移植,12处创面一次性愈合,总治愈率为92.3%。随访半年～3年,创面愈合后无明显瘢痕增生,外观较好,功能佳。结论:VAC联合人工真皮治疗功能部深创面,明显缩短疗程,提高愈合质量,值得进一步推广使用。Objective To summarize good results of vacuum-assisted closure （VAC） combined with artificial dermis （PELNAC） to treat skin and soft tissues defected wounds of functional part, and extends clinical application of the method. Methods 11 patients with 13 wounds, hospitalized from March 2008 to December 2011, were treated with VAC and PELNAC. The traffic accident wounds （9 cases）,injury due to roll by the wire spoke of bicycle（1 cases）, injury due to run-over by the roller coaster （1 cases）, all wounds are situated the joint of lower limbs, deeper tissue exposed（9 cases）, accompanying different degree joint dysfunction. All the patients were given systemic supporting treatment in perioperative period and early debridement, then were treated with VAC. After the fresh granulation tissue formed, did PELNAC graft, when PELNAC vascularized, did epidermal skin graft immediately . Results After treated with VAC, Granulation tissue grow rapidly, covered partial or all exposed deeper tissue. After PELNAC and epidermal skin graft, 12 wounds healed. The total healing rate was 92.3%. After a follow-up 6 to 36months,the healing wounds without hypertrophic scar, appearance speciously, and better function. Conclusion VAC associate with treated the deeper functional joint wounds, shortened the course of treatment obviously and improved the quality of healing. The method is deserved further promotion and application.

关 键 词：封闭式负压引流 创面 人工真皮 刃厚皮片 

分 类 号：R622[医药卫生—整形外科]