腹壁坏死性筋膜炎合并广泛皮肤软组织缺损的修复  

Repair of Necrotizing Fasciitis of Abdominal Wall Complicated with Widespread Soft Tissue Loss

作　　者：张诚[1] 刘毅[1] 孙晓晨[1] 陈黎明[1] 张鲜英[1] 徐承新[1] 陈亮[1] 

机构地区：[1]兰州军区兰州总医院全军烧伤整形外科中心,兰州730050

出　　处：《解放军医药杂志》2013年第12期6-10,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：全军十二五医学科研重点项目(BWS11C061)

摘　　要：目的探讨腹壁广泛坏死性筋膜炎的综合治疗措施和修复方法。方法对2009年8月—2013年5月我院收治的5例严重腹壁坏死性筋膜炎患者进行回顾性分析,其中4例为腹部外科手术后引起,1例为会阴部Fournier坏疽引起。结果 1例腹腔镜胆道手术后因腹腔脓肿并发脓毒性休克死亡;4例治愈,其中3例使用了腹腔冲洗加持续负压吸引治疗(VSD)技术;4例均采用局部皮瓣加自体网状中厚皮移植术和腹壁创面VSD技术成功修复。结论腹壁坏死性筋膜炎合并腹壁软组织缺损,经过持续冲洗VSD后,采用局部皮瓣加大张网状皮覆盖可达到良好修复效果。Objective To explore the combined modality therapy and repair of extensive abdominal necrotizing fasciitis（ NF）. Methods Clinical data of 5 patients with severe necrotizing fascitis of abdominal wall during August 2009 and May 2013 was retrospectively analyzed. Among the 5 patients,4 patients were induced by abdominal operations,and one was caused by ano-genital Fournier gangrene. Results One patient died of peritoneal abscess complicated with septic shock after biliary surgical procedures under laparoscope; 4 patients were cured,including 3 patients were treated with irrigation of peritoneal cavity and continuous vacuum sealing drainage（ VSD） technique; 4 patients were repaired with local flaps combined with large sheet of auto-reticulate split-thickness skin graft and abdominal VSD technique. Conclusion Local flap and large sheet of auto-reticulate split-thickness skin graft after treatment of continuing rinsing and VSD may achieve better repair effect in the necrotizing fascitis of abdominal wall complicated with abdominal soft tissue loss.

关 键 词：筋膜炎 坏死性 腹壁 外科皮瓣 FOURNIER坏疽 

分 类 号：R622.1[医药卫生—整形外科]