封闭式负压引流技术联合皮瓣移植修复足部严重软组织缺损  

Vacuum sealing drainage combined with flap transplantation for repairing foot severe soft tissue defects

作　　者：侯训凯 王炳臣 林永杰[1] 王国伟[1] 石恩东[1] 孙庆山[1] 耿震[1] 毛军胜[1] 

机构地区：[1]山东省交通医院骨科,济南市无影山中路12号250031

出　　处：《中国矫形外科杂志》2015年第19期1779-1782,共4页Orthopedic Journal of China

摘　　要：[目的]探讨封闭式负压引流技术联合皮瓣移植修复足部严重软组织缺损的治疗效果。[方法]2007年5月-2014年5月本院收治的足部严重皮肤软组织缺损患者97例,对临床资料进行回顾性分析。51例列为观察组,实施封闭式负压引流联合皮瓣移植治疗,另外46例列为对照组,实施常规换药后皮瓣移植修复治疗。对两组患者的换药次数,创面缩减程度,愈合时间,感染发生情况,皮瓣成活率以及患肢功能进行分析,评价其临床效果。[结果]观察组换药次数显著少于对照组（t=15.901,P〈0.05）;观察组创面缩减程度明显优于对照组（t=6.085,P〈0.05）;观察组愈合时间明显短于对照组（t=11.201,P〈0.05）。观察组感染发生率显著低于对照组（x2=4.751,P〈0.05）;观察组皮瓣成活率显著高于对照组（x2=4.184,P〈0.05）。所有97例患者均获得随访,随访时间12-15个月,平均13.5个月。末次随访时按照Johner-Wruhs的方法评定功能,观察组优于对照组（x2=9.410,P〈0.05）。[结论]封闭式负压引流技术结合皮瓣移植修复足部严重软组织缺损获得了较好的临床治疗效果,具有较好的临床应用价值。[Objective] To investigate the effect of the vacuum sealing drainage combined with flap transplantation on the repair of foot severe tissue defect. [Method]Ninety seven patients with foot severe tissue defects were surgically treated in our hospital from May 2007 to May 2014. Of them,51 patients were treated with vacuum sealing drainage combined with flap transplantation（ the observation group）,while 46 patients were treated with flap transplantation after traditional dressing change（ the control group）. The dressing change frequency,wound contraction,wound healing time,the incidence of infection,survival rate of flap and the function of the affected extremity were compared between the two groups. [Result]The dressing change frequency in the observation group was significantly less than the control group（ t = 15. 901,P〈0. 05）. The wound contraction in the observation group was significantly more remarkable than the control group as well（ t = 6. 085,P〈0. 05）. Additionally,the healing time in the observation group was significantly shorter than the control group（ t = 11. 201,P〈0. 05）. Furthermore,the incidence of infection in the observation group was significantly less than the control group（ x2= 4. 751,P〈0. 05）. Moreover,the survival rate of flap in the observation group was significantly higher than the control group（ x2= 4. 184,P〈0. 05）. All the 97 patients were followed up for 12- 15 months,with an average of 13. 5 months. According to Johner- Wruhs grading,the observe group was superior to the control group（ x2= 9. 410,P〈0. 05）. [Conclusion]The vacuum sealing drainage combined with flap transplantation for severe foot tissue repair can achieve better outcomes,and has preferable value in clinical application.

关 键 词：封闭式负压引流 皮瓣移植 足部软组织缺损 创面修复 

分 类 号：R658.3[医药卫生—外科学]