封闭负压引流装置联合中厚皮片移植治疗足部碾压伤  

Closed negative pressure drainage device combined with medium-thickness skin graft for foot crush injury

作　　者：郭中帅 陈长青[1] 林东[1] 王升[1] 谢长伟 林栋 崔新华 赵泽[1] GUO Zhong-shuai;CHEN Chang-qing;LIN Dong;WANG Sheng;XIE Chang-wei;LIN Dong;CUI Xin-hua;ZHAO Ze(Jiaozuo Second People's Hospital,Henan Province,454000,China)

机构地区：[1]焦作市第二人民医院骨一科,河南焦作454000

出　　处：《中国医疗美容》2019年第3期34-37,共4页China Medical Cosmetology

摘　　要：目的观察封闭负压引流装置(VSD)联合中厚皮片移植治疗足部软组织碾压伤的临床疗效。方法选取我科2014年7月-2018年4月收治23例足部碾压伤患者,通过早期予彻底清除,创面采用VSD覆盖,待创面肉芽组织满意后,大腿及腹部取中厚游离皮片对创面进行修复。结果 2例患者因肌腱、骨组织外露严重,不能达到良好肉芽覆盖,改皮瓣治疗,15例患者皮片成活95%以上,6例成活90%,未愈合部分通过加强换药,局部应用去腐生肌类中成药膏后全部愈合。供区皮肤均一期愈合。随访6-12个月,皮肤缺损处皮片愈合良好,皮肤色泽可。结论 VSD联合中厚皮片移植治疗足部碾压伤,可以满意修复创面,成活率高,再手术率低,足部外形满意。Objective To observe the clinical effect of closed negative pressure drainage device(VSD)combined with mediumthickness skin graft in the treatment of soft tissue crushing injury of foot.Methods From July 2014 to April 2018,23 patients with crushed foot injuries were treated in our department.The wounds were thoroughly cleared and covered with VSD.After the granulation tissue of the wounds was satisfied,the thighs and abdomen were repaired with medium-thickness free skin grafts.Result Because of the serious exposure of tendon and bone tissue in 2 patients,they could not achieve good granulation coverage.Skin grafts survived more than 95%in 15 patients and 90%in 6 patients.The unhealed part healed completely by strengthening dressing change and topical application of decomposing muscle traditional Chinese medicine ointment.The donor skin healed in one stage.Follow-up for 6-12 months showed that the skin defect healed well and the skin color was acceptable.Conclusion VSD combined with medium-thickness skin graft for foot crush injury can repair the wound satisfactorily with high survival rate,low reoperation rate and satisfactory foot shape.

关 键 词：中厚皮片 足部碾压伤 封闭负压引流装置 

分 类 号：R658.3[医药卫生—外科学]