皮神经营养血管皮瓣结合负压封闭引流在创面修复中的应用  

Clinical application of cutaneous neurovascular flaps combining with vacuum sealing drainage to repair severe wound

作　　者：柏士平[1] 潘拥军[1] 宗艳霞[1] 

机构地区：[1]江西省九江市第一人民医院烧伤整形科,江西九江332000

出　　处：《中国现代医生》2013年第26期71-73,共3页China Modern Doctor

基　　金：江西省九江市第一批社会发展类指导性科研计划项目(九科字[2010]42号)

摘　　要：目的探讨皮神经营养血管皮瓣结合负压封闭引流在复杂创面修复中的临床效果。方法入选患者26例，随机分为试验组和对照组：试验组13例，创面先经负压封闭引流处理5～7d，碘伏换药2～5d，再行皮神经营养血管皮瓣修复：对照组13例，创面常规换药处理后行皮神经营养血管皮瓣修复。观察两组患者创面准备时间、皮瓣成活及创面愈合后外形与功能恢复情况。结果24例患者皮瓣一期存活，试验组和对照组各有1例皮瓣远端部分坏死，经换药后愈合。治疗过程中无大出血、血管神经损伤、感染及皮瓣撕脱等并发症。所有患者均获随访，随访时间12～18个月，皮瓣质地优良，外观无明显臃肿，功能满意。试验组创面准备时间为（9．8±3．2）d，对照组创面准备时间为（14．2±4．5）d，试验组创面准备时间比对照组要短，差异有统计学意义（t=3．522，P〈0．05）。结论皮神经营养血管皮瓣结合负压封闭引流能够缩短治疗时间，成功率高，临床效果满意，是修复各种复杂创面的理想方法之一。Objective To explore the clinical effects of cutaneous neurovascular flaps combining with vacuum sealing drainage on severe wound. Methods All of 26 cases of paients were randomly divided into testing group and control group. 13 cases were treated by cutaneous neurovascular flaps with 57 days vacuum sealing drainage in the testing group and 13 cases were repaired by cutaneous neurovascular flaps after routine dressing change in the control group. The time of wound preparation, survival of flaps, shape and function were compared between two groups. Results 24 cases survived by first intention,parital necrosis in one case of each group healing after dressing. During the treat ment,there were no complications of hemorrhage,vessels and nerves injury,infection and flaps avulsion. All paients were followed up for 1218 months . quality and shape of all the flaps and function recovery of patients were satisfac tory. （9.8±3.2） days for wound preparation in testing group and （14.2±4.5） days in control group,the difference was sta tistical significant（t=3.522,P〈0.05）. Conclusion With short hospitalization time,high survival rate and satisfactory clinical effects,cutaneous neurovascular flaps combining with vacuum sealing drainage is one of good way to repair severe wound.

关 键 词：皮神经营养血管皮瓣 外科皮瓣 负压封闭引流 修复 

分 类 号：R622.1[医药卫生—整形外科]