一期适形皮肤移植术在肛周大面积化脓性汗腺炎手术缺损修复中的应用（附14例报道）  

One-stage skin conformal grafting in the management of large skin defects in patients with perianal hidradenitis suppurativa: a report of 14 cases

作　　者：赵永昌[1] 李玉英[1] 杨小琴 孙锋[1] 韩杰[1] 吴潇烁 汤睿琪 刘姣姣 Zhao Yongchang;Li Yuying;Yang Xiaoqin;Sun Feng;Han Jie;Wu Xiaoshuo;Tang Ruiqi;Liu Jiaojiao(Department of Anorectal Diseases,The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China;Department of Rehabilitation,Yuexiu District Children’s Hospital of Guangzhou,Guangzhou 510000,Guangdong,China;The First Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院肛肠科,广东广州510405 [2]广州市越秀区儿童医院康复科,广东广州510000 [3]广州中医药大学第一临床医学院,广东广州510405

出　　处：《结直肠肛门外科》2020年第1期92-96,共5页Journal of Colorectal & Anal Surgery

摘　　要：目的分析一期适形皮肤移植术在肛周大面积化脓性汗腺炎(HS)手术缺损修复中的应用疗效。方法回顾性分析2015年2月至2018年2月在广州中医药大学第一附属医院诊断为肛周大面积HS需手术治疗的14例患者的临床资料,所有患者均采用常规病灶切除术联合一期适形皮肤移植术治疗,分析患者术后创面愈合时间、复发情况、皮肤修复效果及瘢痕评分(色泽、厚度、血管分布、柔软度)。结果 14例患者术后创面愈合时间12~19 d,平均(14.21±2.33) d;随访12个月,14例患者中,2例复发(在创面愈合后1个月内出现单个局灶性破溃渗液,经非麻醉下扩创引流2周后痊愈,随访均未再见复发),余12例未见复发;14例患者的创面均顺利愈合,移植皮肤大部分成活,小部分皮肤坏死或脱落,其下创面仍能快速完成上皮化且未见明显瘢痕增生,整体创面愈合后局部平整,柔软光滑,未出现皮下血肿或感染,周围器官未发生明显位移或畸形;术后12个月,14例患者温哥华瘢痕评分为色泽评分(1.91±0.18)分、厚度评分(0.76±0.11)分、血管分布评分(0.93±0.26)分、柔软度评分(0.92±0.15)分。结论一期适形皮肤移植术用于肛周大面积化脓性汗腺炎手术缺损的修复具有良好的疗效。Objectives To investigate the effect of one-stage conformal skin grafting in the management of large skin defect caused by hidradenitis suppurativa(HS).Methods This was a retrospective analysis of 14 patients with perianal HS requiring large skin defects repairmen,who were treated at The First Affiliated Hospital of Guangzhou University of Chinese Medicine be⁃tween February 2015 and February 2018.All patients received routine debridement followed by one-stage conformal skin graft⁃ing.Time to wound healing,recurrence,effectiveness of repairment,and scar condition measured by Vancouver Scar Scale(mela⁃nin,height,vascularity and pliability)were recorded.Results Time to wound healing ranged from 12 to 19 days,with an aver⁃age of(14.21±2.33)days.Patients were followed up for 12 months.Two patients had recurrence,involving single localized ulcer⁃ation and oozing.These two patients were drained,and healed in two weeks.No subsequent recurrence was recorded in the re⁃maining 12 cases.Wound healing was satisfactory in all 14 patients.Most of the skin graft survived.Despite small areas of skin necrosis,the underneath underwent epithelialization with no visible proliferative scar.Overall,healed wound was smooth,soft,and pliable,with no hematoma,infection,and internal organ shift or malformation.Vancouver Scar Scale was(1.91±0.18)for mel⁃anin,(0.76±0.11)for height,(0.93±0.26)for vascularity,and(0.92±0.15)for pliability.Conclusion One-stage skin conformal grafting is effective in large defect repairment after hidradenitis suppurativa.

关 键 词：化脓性汗腺炎 适形皮肤移植术 创面修复 

分 类 号：R657.1[医药卫生—外科学]