封闭负压固定技术在特殊部位植皮中的应用  

Application of vacuum sealing fixation technique for skin graft at special position of the body

作　　者：李军[1] 朱靓[2] 徐明达[1] 周琴[1] 程传涛[1] 刘洋[1] 党瑞[1] 杨薛康[1] 韩军涛[1] 胡大海[1] 

机构地区：[1]第四军医大学西京医院烧伤与皮肤外科,陕西西安710032 [2]第四军医大学医学教育研究室

出　　处：《中国美容医学》2013年第14期1472-1475,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:在难以加压固定的特殊部位应用封闭负压技术进行植皮区固定,并观察术后效果,为提高特殊部位植皮成活率提供更好的选择。方法:2012年1月～2013年1月,选取105例颜面部、颈部、腋窝、下腹部,会阴等处瘢痕切除松解后需行植皮术的患者,随机分为两组,分别采用封闭负压固定法或传统加压包扎固定法,观察并比较两组间植皮成活率、术后平均换药次数、二次手术率、术后平均住院时间等。结果:术后封闭负压固定组植皮成活率高于加压固定组(98%vs.92%,P<0.05),术后平均换药次数减少(2.5±0.8 vs.4.3±0.7,P<0.01),二次手术率降低(1.8%vs.6.2%,P<0.01),平均住院时间明显缩短(4.5±1.3 vs.6.7±1.1,P<0.05)。经3个月以上随访,封闭负压固定组皮片外观及功能均达到了较满意的效果。结论:对难以均匀加压及固定的特殊植皮区域,选择封闭负压技术,方法简便易行,能起到良好的加压、固定和引流作用,有效的提高了植皮的成活率。Objective To apply vacuum sealing fixation technique for skin graft at special position of the body and observe the clinical outcome to provide a better choice for skin graft for those positions. Methods From January 2012 to January 2013,105 cases were included who needed skin grafts after scar excision at some special positions of the body,such as face,neck,armpits,abdomen,perineum, where it is hard to apply pressure fixation.The patients were randomly divided into two groups using vacuum sealing fixation technique and the traditional compression method respectively.Such factors were observed and compared between the two groups as the survival rate of the skin grafts,times of dressing changes,second operation rate and the average postoperative hospital stay. Results The survival rate of skin grafts in the vacuum sealing fixation group is higher than that of the traditional compression group （98% vs. 92%, P〈0.05）,with less times of dressing changes （2.5±0.8 vs. 4.3±0.7,P〈 0.01）and lower second operation rate （1.8% vs. 6.2%, P〈0.01）. In addition, the average postoperative hospital stay is also significantly shorter in the vacuum sealing fixation group （4.5±1.3 vs. 6.7±1.1,P〈 0.05）. 3-month follow-ups have suggested that the outer appearance and function of the grafted skins are satisfactory in the vacuum sealing fixation group. Conclusions At those special positions of the body,the vacuum sealing fixation technique is not only simple but very effective for skin grafts.

关 键 词：封闭负压固定技术 加压固定技术 植皮术 

分 类 号：R622[医药卫生—整形外科]