下肢大面积皮肤撕脱伤反取皮植皮并封闭负压引流疗效观察  

Back Implantation of Skin Graft Combining Vaccum Sealing Drainage in the Treatment of Large Skin Avulsion of Lower Extremities

作　　者：李卫华[1] 王晓[1] 张淞[1] 潘华刚[1] 

机构地区：[1]河南大学淮河医院骨科,河南开封475000

出　　处：《创伤与急危重病医学》2015年第6期348-350,共3页Trauma and Critical Care Medicine

摘　　要：目的观察反取皮植皮联合封闭负压引流（VSD）治疗下肢大面积皮肤撕脱伤的临床疗效。方法收集2010年1月至2012年12月收治的下肢大面积皮肤撕脱伤患者13例的临床资料。所有病例均先行急诊手术室彻底清创,反取皮植皮法缝合固定创面,封闭式负压吸引引流5~12 d,视创面及反取皮成活情况,小面积皮肤坏死缺损部分行邮票式游离植皮。结果本组13例均获随访,随访时间12~36个月,平均16个月。无一例患者发生明显感染,经反取皮植皮联合VSD治疗患者创面,75%以上面积成活,对于小部分皮肤坏死创面,后期经邮票式游离植皮或清洁换药后均获愈合,术后膝关节功能良好。结论反取皮植皮联合VSD治疗下肢大面积皮肤撕脱伤,早期关闭了开放创面,在大大降低感染率的同时,促进了皮片与创面的贴服,提高了创面愈合率,改善了关节功能。Objective To investigate the efficacy of back implantation of skin graft combining vacuum sealing drainage（ VSD） in the treatment of large skin avulsion of lower extremities. Methods From January 2010 to December 2012 13 cases of lower limb large area skin avulsion injury the clinical data were collected. Among them,8 cases were male and 5 cases were female with age range from 4 to 59 years old（ average age 36 years old）. All cases were performed emergency operation through debridement,back implantation of skin graft to suture wound,enclosed pressure suction drainage with VSD for 5to 12 days,depending on the wound and skin survival situation. Small area of skin necrosis defect part was performed stamp type free skin graft. Results All of 13 patients had been followed up and the follow-up time was from 12 to 36 months with an average of 16 months. Patients were not found infection and more than 75% of the area of skin graft was survival. Small wound skin necrosis got healing in the later stamp type free skin graft or clean dressing. Postoperative knee function was good. Conclusion Back implantation of skin graft combining vacuum sealing drainage in the treatment of large skin avulsion of lower extremities can realize the early closed open wounds. While greatly reducing the infection rate,this method can promote the skin and wound stick,improve the wound healing rate and the joint function.

关 键 词：皮肤撕脱伤 大面积植皮 反取皮 封闭负压引流 

分 类 号：R641[医药卫生—外科学] R751.05[医药卫生—临床医学]