二期皮片移植联合VSD负压吸引治疗阴囊撕脱伤  

Second stage skin graft combined with VSD negative pressure suction for scrotal avulsion

作　　者：王海清 刘飞飞[1] 张盈 刘文明[1] WANG Hai-qing;LIU Fei-fei;ZHANG Ying;LIU Wen-ming(Department of burning and plastic surgery,Binzhou medical college affiliated hospital,Shandong Province,256600,China)

机构地区：[1]滨州医学院附属医院烧伤整形外科,山东滨州256600

出　　处：《中国医疗美容》2020年第10期52-56,共5页China Medical Cosmetology

摘　　要：目的探讨一期清创二期全厚皮片游离移植联合VSD负压吸引技术重建阴囊的临床疗效。方法对自2017年9月至2018年9月,滨州医学院附属医院烧伤整形外科收治的8例阴囊撕脱伤患者,一期清创,清除坏死组织及异物等,外用湿润烧伤膏促进肉芽生长及坏死组织脱落。二期取全厚皮片游离移植于创面,外接VSD负压吸引装置,术后10天拆除VSD装置,观察皮片成活的情况。结果本组共8例患者,皮片均一期成活,无明显感染、皮下积液、皮片坏死及瘢痕增生等并发症。随访6~24个月,阴囊皮肤外观颜色、质地、柔韧度均可,精液检查无明显异常。结论一期清创促进创面生长,二期全厚皮片移植联合VSD负压吸引技术治疗阴囊撕脱伤,能有效解决一期移植皮片成活率低以及因特殊部位加压包扎困难造成的皮下积血积液、感染的问题;最大限度的保留了阴囊调节局部温度的能力,不干扰睾丸的精子发生;且术后瘢痕不明显,达到较好的美观效果,最大限度恢复完整的阴囊结构及功能。Objective To investigate the clinical effect of full thickness skin free transplantation combined with VSD negative pressure suction technique for scrotal reconstruction.Methods A primary debridement was performed on 8 patients with avulsion of scrotum admitted to the Burn plastic Surgery Department of Binzhou Medical College from September 2017 to September 2018 to remove necrotic tissues and foreign bodies.MEBO was applied externally to promote the growth of granulas and the shedding of necrotic tissues.In the second stage,the whole thick skin was free transplanted to the wound surface,and the VSD negative pressure suction device was attached externally.The VSD device was removed 10 days after the operation,and the survival of the skin was observed.Results There were 8 patients in this group,all the skin slides survived in the first stage,and there were no obvious complications such as infection,subcutaneous hydrops,skin necrosis and scar hyperplasia.Follow up for 6~24 months,scrotal skin appearance color,texture,flexibility can be,semen examination no obvious abnormality.Conclusion One-stage debridement can promote the growth of wound surface,and two-stage full-thickness skin graft combined with VSD negative pressure suction technique can effectively solve the problems of low survival rate of one-stage skin graft and subcutaneous hematocellosis and infection caused by the difficulty in compression binding of special sites.It retains the scrotum's ability to regulate local temperature to the maximum extent without interfering with spermatogenesis of testis.And the postoperative scar is not obvious,to achieve a better aesthetic effect,to maximize the restoration of complete scrotal structure and function.

关 键 词：阴囊重建 阴囊撕脱伤 全厚皮片移植 VSD负压吸引 

分 类 号：R699.8[医药卫生—泌尿科学]