平行克氏针皮肤牵张术在软组织缺损修复中的应用  

Application of Parallel Kirschner Needle Skin Distraction Technique in the Repair of Soft Tissue Defects

作　　者：戴伟[1] 莫林海 张慧 张斌[1] 李昌坤[1] 杨先武[1] 程翔[1] 王乾坤 梁耘[1] 古世伟 张伟 DAI - Wei;MO Lin - Hai;ZhangHui(Department of orthopaedics, Jiangyou Peoplec hospital, Sichuan 621700)

机构地区：[1]江油市人民医院骨科,四川江油621700 [2]四川省康复医院

出　　处：《中国伤残医学》2019年第11期13-16,共4页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨改良皮肤牵张术在皮肤软组织缺损中的临床应用价值.方法:选取自2015年2月-2017年5月,我院创伤骨科诊治的36例皮肤软组织缺损病例中,采用简易改良皮肤牵张术式治疗18例(观察组;改良皮肤牵张术式组),采用常规植皮术式治疗18例(对照组;植皮组).对比2组住院时间、再次手术率、手术及治疗费用、患者满意度.结果:36例均获得1-2个月随访,创口愈合良好32例,创口感染不愈合3例、创口延迟愈合1例,无再次骨外露,局部感觉、功能良好.观察组1例在皮肤牵张术后皮肤撕裂,皮肤牵张失败,局部创面2期行植皮术,创口延迟愈合.对照组3例术后出现感染,1例植皮区愈合<50%,植皮术失败,局部创面行再植皮术后愈合;1例再次植皮术后失败,行局部皮瓣转移术术后愈合;1例创口不愈合.2组术后感染发生例数比较差异无统计学意义(P=0.550).观察组再次手术例数明显少于对照组,差异有统计学意义(P=0.007).观察组伤口愈合时间较对照组短,差异有统计学意义(P=0.010).观察组手术费用明显低于对照组,差异有统计学意义(P=0.007).观察组术后患者满意度明显高于对照组,差异有统计学意义(P=0.010).结论:改良皮肤牵张术在皮肤软组织缺损创伤治疗中,较常规植皮术式相比,改良皮肤牵张术在皮肤缺损创面修复中,更简单、高效,能缩短创面愈合时间,愈合瘢痕小,患者满意度更高.Objective: To investigate the clinical application of improved skin stretch operation in repairing large area skin defect. Methods: Between February 2015 and May 2017 in our hospital orthopaedic trauma department, 36 cases of skin and soft tissue defects were divided into treatment groups (18 cases) with improved skin stretch operationand control groups (18 cases ) with normaldermepenthe sis. The cases of wound infection and reoperation, the time of wound healing, cost of surgery and satisfaction level of patients were used to evaluate. Results: After 1 -2 months of follow - up,32 cases of wound healed well both in treatment groups and control groups. 1 case of skin in treatment groups teared and need the second skin grafting. While 3 cases of skin in control groups were infected;one of wound healed after the second skin grafting as the area of wound heal was less than 50% with normal dermepenthesis;one of wound healed after flap repairing as failing to the second skin grafting;one of wound was disunion. The cases of wound infection after treatment between two groups has no statistical difference(P =0. 550). Compare with control groups,the cases of reoperation in treatment groups were more low? er,which has significantly statistical difference( P =0. 007 ). The time of wound healing and cost of surgery in treatment groups were less than control groups , while patients treated with improved skin stretch operation reported significantly higer treatment satisfaction than con? trol groups. All of these differences were statistically significant, as P value were 0. 010. Conclusion: Theimproved skin stretch operationcan reduce the wound healing timeand promote higer satisfaction compared with normal dermepenthesis. It was a simple and high efficiency method for the treatment of skin and soft tissue defect.

关 键 词：皮肤缺损 皮肤牵张术 植皮术 修复 

分 类 号：R687[医药卫生—骨科学]