延时皮肤牵拉器在皮肤软组织缺损治疗中的应用  

Application of delayed skin-stretching device in treatment of skin and soft tissue defects

作　　者：宋文吉 苑博[1] 赵正南 童致虹[1] 梁海东[1] SONG Wenji;YUAN Bo;ZHAO Zhengnan;TONG Zhihong;LIANG Haidong(Department of Hand and Foot Surgery,the Second Hospital of Dalian Medical University,Dalian LiaoninE,116023,P.R.China)

机构地区：[1]大连医科大学附属第二医院手足外科,辽宁大连116023

出　　处：《中国修复重建外科杂志》2018年第10期1281-1285,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的总结延时皮肤牵拉器治疗皮肤软组织缺损的临床效果。方法 2014年12月—2016年12月,采用延时皮肤牵拉器治疗皮肤软组织缺损10例。男6例,女4例;年龄42~64岁,平均53岁。急性创伤致皮肤软组织缺损6例,骨筋膜室综合征切开后切口无法闭合3例,巨大痈切开引流后皮肤软组织缺损1例。缺损部位:大腿4例,小腿3例,上臂2例,背部1例。缺损范围为10 cm×4 cm^22 cm×12 cm。创缘行Pinch试验,确认创面均无法直接闭合。结果牵拉过程中,3例出现张力性水疱;无创缘血运不畅、皮肤坏死等并发症发生。10例患者创面经过7~18 d持续牵拉后明显缩小,均直接拉拢缝合;无植皮或游离皮瓣手术者。术后创口愈合良好。10例患者均获随访,随访时间5~8个月,平均6.5个月。创缘周围均无坏死,瘢痕呈线性,感觉及功能不受影响。结论采用延时皮肤牵拉器治疗皮肤软组织缺损操作简便、手术风险低、并发症少,可获得较好疗效。Objective To summarize the effectiveness of delayed skin-stretching device in treatment of skin and soft tissue defects. Methods Between December 2014 and December 2016, 10 cases of skin and soft tissue defects were treated with delayed skin-stretching device. There were 6 males and 4 females with an average age of 53 years（range, 42-64 years）. The skin and soft tissue defects were caused by acute trauma in 6 cases. The incision could not be closed directly after making incisions because of osseous fascia syndrome in 3 cases. The skin soft tissue defect caused after huge carbuncle incision and drainage in 1 case. The defect located at thigh in 4 cases, lower leg in 3 cases, upper arm in 2 cases,back in 1 case. The defect area ranged from 10 cm×4 cm to 22 cm×12 cm. Pinch test was performed on the wound margin,which confirmed that the wound could not be closed directly. Results Tension blisters were found in 3 cases during traction, and no complications such as impaired blood circulation or skin necrosis occurred in all cases. Skin defects closed directly after continuously stretching for 7-18 days. No skin graft or free flap repair was performed in all patients.The wound healed well after operation. All the 10 patients were followed up 5-8 months（mean, 6.5 months）. There was no necrosis around the wound margin and the scar was linear. The sensation and function were not affected. Conclusion Delayed skin-stretching device is an effective method to treat skin and soft tissue defects, which has the advantages of simple operation, lower risk of operation, less complications, and reliable effectiveness.

关 键 词：皮肤软组织缺损 延时皮肤牵拉器 皮肤牵张法 

分 类 号：R622[医药卫生—整形外科]