翻卷技术的带蒂筋膜瓣联合游离植皮替代游离皮瓣治疗骨、肌腱外露创面的临床效果  

Clinical effect of pedicled fascia flap combined with free skin graft instead of free skin flap in the treatment of exposed bone and tendon wounds

作　　者：黄谋璋 郭九生 朱小荣 HUANG Mou-zhang;GUO Jiu-sheng;ZHU Xiao-rong(Department of Emergency Trauma Surgery,Ganzhou People′s Hospital,Jiangxi Province,Ganzhou341000,China;Department of Joint Surgery,People′s Hospital of Yudu County,Jiangxi Province,Yudu342300,China;Department of Orthopedics and Traumatology,Xingguo Hospital of Traditional Chinese Medicine,Jiangxi Province,Xingguo342400,China)

机构地区：[1]江西省赣州市人民医院急诊创伤外科,江西赣州341000 [2]江西省赣州市于都县人民医院关节外科,江西于都342300 [3]江西省赣州市兴国县中医院骨伤二科,江西兴国342400

出　　处：《中国当代医药》2021年第29期91-93,97,共4页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2020ZSF242)。

摘　　要：目的探讨翻卷技术的带蒂筋膜瓣联合游离植皮替代游离皮瓣治疗骨、肌腱外露创面的临床效果。方法选取2020年3月至2021年2月赣州市人民医院急诊创伤外科收治的60例骨、肌腱外露创面患者为研究对象,按照随机数字表法分成对照组(30例)与观察组(30例)。对照组采取翻转技术的传统筋膜瓣翻转治疗,观察组采用翻卷技术的带蒂筋膜瓣联合游离植皮替代游离皮瓣治疗,比较两组创面感染率、植皮存活率、创面一次愈合率,视觉模拟评分法(VAS)评分。结果观察组创面一次愈合率(73.33%)、植皮存活率(90.00%)高于对照组(36.67%、50.00%),观察组创面感染率(3.33%)低于对照组(26.67%),差异有统计学意义(P<0.05)。术前,两组VAS评分比较,差异无统计学意义(P>0.05);术后,两组VAS评分低于术前,观察组VAS评分低于对照组,差异有统计学意义(P<0.05)。结论针对骨、肌腱外露创面患者,采用翻卷技术的带蒂筋膜瓣与游离植皮联合治疗,效果更佳,能降低创面感染率,提高植皮存活率及创面一次愈合率,减轻疼痛,临床应用价值突出。Objective To explore the clinical effect of pedicled fascia flap combined with free skin graft instead of free skin flap in the treatment of bone and tendon exposed wounds.Methods A total of 60 patients with exposed bone and tendon wounds admitted to the Department of Emergency Traumatology of Ganzhou People′s Hospital from March 2020 to February 2021 were selected as the research objects,and were divided into a control group(30 cases)and an observation group(30 cases)according to a random number table method.The control group was treated with the traditional fascia flap with the flip technique,and the observation group was treated with the pedicled fascia flap with the roll technique combined with free skin graft instead of free flap.Wound infection rate,skin graft survival rate,wound healing rate and visual analog scale(VAS)score were compared between the two groups.Results The wound healing rate(73.33%)and skin graft survival rate(90.00%)in the observation group were higher than those in the control group(36.67%and 50.00%),and the wound infection rate in the observation group(3.33%)was lower than that in the control group(26.67%),the differences were statistically significant(P<0.05).Preoperative comparison of VAS scores between the two groups showed no statistical significance(P>0.05).After surgery,VAS scores of the two groups were lower than those before surgery,and VAS score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05).Conclusion For patients with exposed bone and tendon wounds,the combined treatment of pedicled fascia flaps and free skin grafts with the rolling technique is effective.It can reduce the infection rate of the wound,increase the survival rate of the skin graft and the rate of one-time wound healing,reduce pain,and the clinical application value is outstanding.

关 键 词：骨、肌腱外露创面 游离植皮 皮瓣游离 翻卷技术 带蒂筋膜瓣 

分 类 号：R687.2[医药卫生—骨科学]