封闭式负压引流术联合游离股前外侧穿支皮瓣治疗儿童下肢大面积皮肤缺损的临床效果分析  

Analysis of the curative effect of vacuum sealing drainage combined with free lateral thigh skin flap in the treatment of children with lower limb large area skin defect

作　　者：王伟[1] 任小宝[1] 陈翔宇[1] 刘明华[1] 苟亚军[1] 

机构地区：[1]第三军医大学第一附属医院急救部,重庆400038

出　　处：《中国医学前沿杂志（电子版）》2016年第8期107-110,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的分析封闭式负压引流术(vacuum sealing drainage,VSD)联合游离股前外侧穿支皮瓣治疗儿童下肢大面积皮肤缺损的临床效果。方法选取本院2013年4月至2015年4月收治的44例下肢大面积皮肤缺损患儿为研究对象,采用随机数表法将入选患儿分为观察组与对照组,每组各22例。两组患儿均应用游离股前外侧穿支皮瓣植皮治疗,观察组患儿采用VSD敷料覆盖,对照组患儿采用传统加压包扎。比较两组患儿植皮成活率和创面感染率。结果观察组患儿植皮全部成活率显著高于对照组(P<0.05),创面感染率显著低于对照组(P<0.05)。44例患儿均获得有效随访,末次随访时,观察组患儿移植皮瓣颜色、质地均较佳,肢体功能恢复良好,无需进行二次手术;对照组4例患儿皮瓣较臃肿,1例患儿返院接受二次手术。结论 VSD有利于移植皮瓣的成活,可降低皮瓣坏死率和创面感染率,能够促进患肢外观和功能的恢复,操作方便,疗效可靠,值得临床推广应用。Objective To analyze the curative effect of vacuum sealing drainage（VSD） combined with free lateral thigh skin flap in the treatment of children with lower limb large area skin defect. Method 44 cases of children with lower limbs large skin defect treated in our hospital from April 2013 to April 2015 were selected as the subjects of study. They were divided into observation group and control group according to the random number table method, 22 cases in each group. They both got the application of free anterolateral thigh perforator flap grafting treatment, observation group children were treated with VSD bandaging, control group children used conventional compression bandage. Compared the survival rate of skin graft and infection rate between the two groups. Result The skin grafting survived rate of observation group was significantly higher than control group（P〈0.05）, the infection rate was significantly lower than control group（P〈0.05）. Effective follow-up was obtained in 44 children. At the last follow-up, the color and texture of the transplanted skin flap in observation group were satisfied those and the function of limbs showed good recovery well. There was no need for the second plastic surgery. 4 cases of children in control group with bulky flaps, 1 child received second plastic surgery. Conclusion VSD is beneficial to the survival of skin graft, to reduce the rate of skin flap necrosis and wound infection. It can guarantee the recovery of the appearance and function of the affected limb, which is convenient to operate and reliable.

关 键 词：封闭式负压引流术 股前外侧穿支皮瓣 下肢大面积皮肤缺损 植皮 

分 类 号：R726.5[医药卫生—儿科]