封闭引流联合富血小板血浆治疗上肢皮肤脱套伤  

Vacuum sealing drainage combined with platelet rich plasma for large degloving injury of upper extremity

作　　者：李飞 付磊 张龙 郭德亮 王根 孙圣亮 赵刚 邰国梁 范韶光 王剑利 LI Fei;FU Lei;ZHANG Long;GUO De-liang;WANG Gen;SUN Sheng-liang;ZHAO Gang;TAI Guo-liang;FAN Shaoguang;WANG Jian-li(Teaching Department of Surgery,Weifang Medical University,Weifang 261021,China;PLA Insti-tute of Orthopaedics and Traumatology,The 80 th Group Army Hospital,Weifang 261021,China)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261021 [2]解放军第八十集团军医院全军创伤骨科研究所,山东潍坊261021

出　　处：《中国矫形外科杂志》2020年第18期1654-1657,共4页Orthopedic Journal of China

摘　　要：[目的]观察真空封闭引流(VSD)联合富血小板血浆(PRP)治疗上肢大面积皮肤脱套伤的疗效。[方法] 2014年1月~2018年6月,共60例上肢大面积皮肤脱套伤患者纳入本研究。依据患者是否使用PRP,将患者分为两组。清创修整成中厚皮片后,28例患者采用单纯VSD,32例患者采用VSD联合PRP治疗。比较两组的临床资料。[结果]两组患者手术均顺利完成。两组患者手术时间、术中失血量的差异无统计学意义(P>0.05)。但是,VSD+PRP组术后换药次数、拆线时间、皮肤成活面积率、皮片坏死面积率和住院时间均优于VSD组(P<0.05)。随访16~42个月,平均(30.14±9.32)个月,两组患者伤肢疼痛逐渐减轻,功能逐渐恢复。末次随访时,两组患者色素沉着、皮片挛缩、瘢痕增生的发生率差异均无统计学意义(P>0.05)。[结论]真空封闭引流联合富血小板血浆治疗上肢大面积皮肤脱套伤可有效提高皮肤成活率,缩短住院时间。[Objective] To observe the effect of vacuum sealing drainage(VSD) combined with platelet rich plasma(PRP)in the treatment of large area skin degloving injury of upper limbs. [Methods] From January 2014 to June 2018, a total of 60 patients with large area skin degloving injury of upper limbs were included in this study. Patients were divided into two groups according to whether they used PRP or not. After debridement, 28 patients were treated with VSD alone and 32 patients were treated with VSD combined with PRP. The clinical data of the two groups were compared. [Results] The operation was successfully completed in both groups. There was no significant difference in operation time and blood loss between the two groups(P>0.05). However, the frequency of dressing change, suture removal time, skin survival area rate, skin necrosis area rate and hospital stay in VSD + PRP group were significantly better than those in VSD group(P<0.05). The patients were followed up for16-42 months(mean, 30.14±9.32 months). At the last follow-up, there was no significant difference in the incidence of pigmentation, skin contracture and scar hyperplasia between the two groups(P>0.05). [Conclusion] The VSD combined with PRP can effectively improve the survival rate of skin and shorten the hospitalization time of patients.

关 键 词：脱套伤 真空封闭引流 富血小板血浆 皮肤回植 

分 类 号：R683.41[医药卫生—骨科学]