反鼓式皮片移植联合负压封闭引流治疗大面积皮肤撕脱伤  

Anti-drum skin grafting combined with vacuum sealing drainage for treatment of large area skin avulsion injury

作　　者：韩志新 杜卫祺 牛大伟 樊昌伟 李振超[1] 狄海萍[3] Han Zhixin;Du Weiqi;Niu Dawei;Fan Changwei;Li Zhenchao;Di Haiping(Department of Burns and Plastics,Anyang People′s Hospital,Anyang 455000,China;Department of Emergency,Hebei Provincial Corps Hospital of Chinese Armed Police Corps,Shijiazhuan 050081,China;Department of Burns,Zhengzhou First People′s Hospital,Zhengzhou 450004,China)

机构地区：[1]安阳市人民医院烧伤整形科,455000 [2]武警河北省总队医院急诊科,石家庄050081 [3]郑州市第一人民医院烧伤科,450004

出　　处：《中华损伤与修复杂志（电子版）》2021年第3期251-256,共6页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20191274、LHGJ20191000);安阳市科研攻关项目(2021C01SF047)。

摘　　要：目的探讨反鼓式皮片移植联合负压封闭引流(VSD)技术修复大面积皮肤撕脱伤的可行性及临床效果。方法回顾性分析安阳市人民医院烧伤整形科在2017年2月至2020年8月收治的不同原因所致的大面积皮肤撕脱伤病例40例,按照手术方式不同分成试验组和对照组,每组各20例。试验组患者应用反鼓式皮片移植联合VSD技术修复创面;对照组患者应用反鼓式取皮回植术修复创面;比较2组患者术后10 d皮片成活率、手术次数、住院费用、住院时间以及术后并发症发生情况与术后6个月瘢痕增生情况。对数据行t检验和χ^(2)检验。结果试验组皮片成活率[(85.9±1.3)%]较对照组[(77.5±3.5)%]明显升高,差异有统计学意义(t=8.40,P=0.01);试验组患者手术次数[(1.9±0.9)次]、住院费用[(2.7±0.8)万元]、住院时间[(25.6±8.0)d],与对照组[(2.5±1.5)次、(3.9±1.0)万元、(41.6±12.5)d]相比,差异均有统计学意义(t=3.31、1.38、4.18,P<0.05);试验组术后4例发生并发症,对照组术后9例发生并发症,比较差异无统计学意义(χ^(2)=1.9,P=0.168);术后6个月,试验组患者瘢痕增生情况整体轻于对照组,差异有统计学意义(χ^(2)=9.17,P=0.01)。结论反鼓式皮片移植联合VSD在修复皮肤撕脱伤方面具有较好的临床效果,瘢痕轻,修复时间短,值得临床上推广。Objective To investigate the feasibility and clinical effect of anti-drum skin grafting combined with vacuum sealing drainage(VSD)in repairing large area skin avulsion injury.Methods From February 2017 to August 2020,40 patients with large area skin avulsion injury were treated in the Department of Burns and Plastic Surgery,Anyang People′s Hospital.The patients were divided into the experimental group and the control group according to the surgical method,20 patients in each group.The patients of study group were treated with anti-drum skin grafting combined with VSD.The patients in the control group were treated with anti-drum skin grafting and reinplantation to repair the wound.The survival rate of skin grafts 10 days after the operation the number of operations,the cost of hospitalization and the length of hospitalization were compared between the 2 groups.As well as the incidence of postoperative complications and scar hyperplasia 6 months after the operation.Data was processed witht test andχ^(2) test.Results The survival rate of skin grafts in experimental group[(85.9±1.3)%]was significantly higher than that in control group[(77.5±3.5)%],and the difference was statistically significant(t=8.40,P =0.01).The number of operations,the cost of hospitalization and length of hospitalization of the experimental group were[(1.9±0.9)times,(2.7±0.8)ten thousand yuan,(25.6±8.0)d],and the control group were[(2.5±1.5)times,(3.9±1.0)ten thousand yuan,(41.6±12.5)d],there were statistically significant differences between the two groups(t=3.31,1.38,4.18;P< 0.05).Four patients occurred postoperative complications in experimental group,while 9 patients occurred in control group,and there was no significant difference between two groups(χ^(2)=1.91,P =0.168).The postoperative scar hyperplasia 6 months after the operation in experimental group was lighter than that in control group,the difference was statistically significant(χ^(2)=9.17,P =0.01).Conclusion Anti-drum skin grafting combined with VSD has good clinical e

关 键 词：创伤和损伤 皮肤移植 负压伤口疗法 

分 类 号：R622.1[医药卫生—整形外科]