负压封闭引流在肛周Paget病术后创面修复中的应用  

Application of vacuum sealing drainage in repairing the postoperative wound of perianal Paget's disease

作　　者：时佳子[1] 翟骁[2] 朱彬蔚[1] 崔进[2] 毕宏达[3] 

机构地区：[1]第二军医大学附属长征医院研究生队,上海200433 [2]第二军医大学附属长海医院本科生队 [3]第二军医大学附属长海医院整形外科

出　　处：《中国美容整形外科杂志》2016年第4期209-211,共3页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：国家自然科学青年基金(81401537)

摘　　要：目的观察负压封闭引流技术结合皮片移植修复肛周Paget病肿瘤扩大切除术后创面的疗效。方法自2009年10月至2013年12月,收治肛周非浸润性Paget病9例,d全身麻醉下行肿瘤扩大切除术;术后取自体一侧股后皮片移植修复创面,负压封闭引流固定皮片,持续负压吸引,定期更换敷料;观察有无感染、血肿等并发症发生,皮片存活情况,术后6个月随访肛门外观及功能重建情况。结果术后7 d,9例患者移植皮片均存活,1例患者术后3 d打开敷料后发现污染。6个月随访时未见肿瘤复发,移植皮片柔软,肛门周围可见自然褶皱,无一例排便功能障碍。结论负压封闭引流技术结合皮片移植用于肛周Paget病术后创面的修复可取得较满意的效果,值得在临床上推广。Objective To observe the effect of vacuum sealing drainage （VSD） combined with skin graft on repairing the postoperative wound of patients with perianal Paget＇s disease （PPD）. Methods From October 2009 to December 2013, 9 patients with non-invasive PPD accepted wide local excision of the lesion under general anesthesia, the self-skin graft was harvested from the lateral thigh was harvested for cover the surgical wound, and then the flap was fixed by VSD with lasting vacuum aspiration and the dressing changed regularly. The survival of the the grafted-skin as well as complications such as infection and hematoma were recorded. Follow-up was performed after the operation for 6 months, and the anal cosmetic and functional reconstruction were evaluated. Results All grafted-skin survived at 7 days after surgery. Pollution occurred in one case at 3 days after operation. After 6 months follow-up, all were satisfied with soft grafted flap, natural fold around the anus, normal bowel movements and no tumor recurrence. Conclusion VSD can be used to repair for repairing the postoperative wound in perianal Paget＇s disease. The therapeutic effect is satisfactory.

关 键 词：负压封闭引流 肛周PAGET病 皮片移植 肛周创面修复 外科手术 

分 类 号：R739.5[医药卫生—肿瘤]