负压创面治疗技术联合整张中厚皮片移植修复肉芽创面  

Clinical Application of Negative Pressure Wound Therapy(NPWT)Combined with Split Thickness Skin Graft in Granulation Stage Wounds Repair

作　　者：黄雄梅 郑胜武[1] 严芳 王燕[1] HUANG Xiong-mei;ZHENG Sheng-wu;YAN Fang;WANG Yan(Department of Burn and Plastic Surgery,Fujian Provincial Clinical Medical College,Fujian Medical University,Fujian Provincial Hospital,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学省立临床医学院福建省立医院整形烧伤科,福建福州350001

出　　处：《中国美容医学》2020年第9期81-84,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探讨负压创面治疗技术(Negative pressure wound therapy,NPWT)联合整张中厚皮片移植修复肉芽创面的临床效果。方法:2015年6月-2018年2月,采用分期手术修复创面的治疗手段,一期清创后创面及空腔填塞放置负压引流系统,封闭创面后间歇负压(300~450mmHg)引流4~16d。培育肉芽组织生长良好后,二期手术持续负压(125~150mmHg)引流联合植皮闭合创面。结果:所有创面伤口愈合良好,疗效满意,皮片色泽弹性良好,无明显瘢痕挛缩,平均住院时间约16.5d。1例口服羟基脲合并糖尿病溃疡患者术后2个月再次出现溃疡,停药后好转。结论:NPWT联合整张中厚皮片移植对于肉芽创面安全有效,减少了患者住院时间,减少抗生素使用时长,减少总花费,同时其外观满意,瘢痕挛缩少,肢体功能良好,提高了患者生活质量。Objective To investigate the clinical effect of negative pressure wound therapy(NPWT)combined with the split thickness skin graft in patients with granulation wounds.Methods Fifty patients who attended our wound care centre between June 2015 and February 2018 were recruited into this study.They were first treated using intermittent negative pressure(300-450mmHg)for 4-16d after wound debridement.The wounds were then grafted with split thickness skin grafts followed by sustenance negative pressure wound therapy of 125-150mmHg provided between 6 up to 38 months(average 22 months).Results The findings from follow-up studies indicated that all cases in treatment group healed well,with satisfactory skin regenerative effect normal color and good elasticity,without scarring or contracture formation.The average hospitalization time for the majority of the patients was about 16.5 days.Only one case of a diabetic foot ulcer taking hydroxycarbamide relapsed after post-operation.However,the wound granulation and healing improved after drug withdrawal.Conclusion NPWT combined with the split thickness skin grafts in patients with granulation stage wounds was a safe and effective surgical method for granulation wound healing.It did not only reduce hospitalization time and antibiotic usage time,it also showed greater costeffectiveness as well as reduced further scarring,contracture formation,and improved quality-adjusted life for years.

关 键 词：负压创面治疗技术 分期手术 中厚皮片 整张皮片移植 修复 肉芽创面 

分 类 号：R622[医药卫生—整形外科]