多种肌皮瓣移植联合负压封闭引流治疗难愈性创面  

Multiple myocutaneous flap transplantation combined with vacuum sealing drainage in treating refractory wounds

作　　者：杨卫玺[1] 程宏宇[1] 於国军[1] 张大维[1] 万能[1] 王晶[1] 孙勇[1] 王一兵[1] Yang Weixi;Cheng Hongyu;Wu Guojun;Zhang Dawei;Wan Neng;Wang Jing;Sun Yong;Wang Yibing(Department of Burns and Plastic Surgery,Huai′an First People′s Hospital,Huai′an 223000,China)

机构地区：[1]淮安市第一人民医院烧伤整形科

出　　处：《中华损伤与修复杂志（电子版）》2019年第6期435-438,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的观察应用肌皮瓣移植联合负压封闭引流治疗烧创伤难愈性创面的临床效果。方法2013年5月至2018年5月淮安市第一人民医院烧伤整形科收治烧伤形成的瘢痕、溃疡创面以及创伤后形成的深部组织外露伴有感染的16例患者,创面面积为3.5 cm×3.2 cm^21.0 cm×12.0 cm,彻底清创后先采用1次或多次负压封闭引流治疗5~7 d,待创面条件改善后分别采用腓肠肌肌皮瓣加植皮、腹直肌肌皮瓣、背阔肌肌皮瓣、臀大肌肌皮瓣等转移覆盖创面。结果16例患者肌皮瓣均完全成活,切口愈合良好,平均住院时间为23 d,创面有效修复。经过6~12个月门诊或电话随访,皮瓣外形、色泽及功能无明显异常,创面未再破溃。结论负压封闭引流结合皮瓣移植修复治疗烧创伤难愈性创面,可获得较好的临床效果。Objective To observe the clinical effect of myocutaneous flap transplantation combined with vacuum sealing drainage in treating refractory burn wounds.Methods Sixteen patients with scar formed by burn,ulcer wound,deep tissue exposed and infection from May 2013 to May 2018 in Department of Burns and Plastic Surgery,Huai′an First People′s Hospital.The area of the wound was 3.5 cm×3.2 cm-21.00 cm×12.0 cm.The wounds were treated with vacuum sealing drainage once or many times for 5-7 days after thorough debridement.After the improvement of the wound conditions,the skin flap of gastrocnemius muscle,rectus abdominis muscle flap,latissimus dorsi muscle flap,gluteus maximus muscle flap and other musculocutaneous flaps were used to cover the wound.Results All the 16 flaps of the patients survived completely and the wound healed well.The average hospitalization time was 23 days.The wounds were repaired effectively.After 6-12 months of outpatient or telephone follow-up,the shape,color and function of the flaps were well,and the wounds were not broken again.Conclusion Vacuum sealing drainage combines with skin flap transplantation can achieve better clinical results in the treatment of refractory burn wounds.

关 键 词：创伤和损伤 外科皮瓣 负压伤口疗法 皮肤移植 

分 类 号：R47[医药卫生—护理学]