持续负压伤口疗法与常规打包加压包扎在难固定部位创面中厚皮移植术中的应用比较  

Comparison of continuous negative pressure wound therapy and conventional packing and pressure bandage in medium thick skin transplantation of difficult to fix wounds

作　　者：谢丰松 吕朝阳 陈传亮 邓磊 黄成 姜凡 Xie Fengsong;Lyu Chaoyang;Chen Chuanliang;Deng Lei;Huang Cheng;Jiang Fan(Department of Burn and Plastic Surgery,Suizhou Hospital Afiliated to Hubei Medical College,Suizhou 441300,China)

机构地区：[1]湖北医药学院附属随州医院烧伤整形外科,441300

出　　处：《中国医师杂志》2021年第11期1686-1689,共4页Journal of Chinese Physician

摘　　要：目的探讨持续负压伤口疗法与常规打包加压包扎在难固定部位创面中厚皮移植术中应用比较。方法选取2019年3月至2020年3月期间在湖北医药学院附属随州医院行难固定部位创面中厚皮移植术患者96例,根据患者术后难固定部位是否采用持续负压伤口疗法分为两组,对照组48例患者实施常规打包加压包扎,观察组48例患者实施持续负压伤口疗法。比较两组患者白细胞(WBC)、C-反应蛋白(CRP)水平、皮片成活面积、皮片血肿面积、皮片成活比例、皮片血肿比例、住院时间及并发症发生率等指标。结果两组治疗后7、14 d WBC、CRP水平均较治疗前显著降低(P<0.05);观察组治疗后7、14 d WBC、CRP水平明显低于对照组(P<0.05);观察组皮片成活面积、皮片成活比例明显高于对照组(P<0.05);观察组皮片血肿面积、皮片血肿比例明显小于对照组(P<0.05);观察组住院时间较对照组显著缩短(t=10.472,P=0.001);观察组皮片并发症发生率明显低于对照组(2.08%vs 12.50%,χ^(2)=10.174,P=0.015)。结论固定部位创面中厚皮移植术中持续负压伤口疗法与常规打包加压包扎比较,前者在提高皮片成活面积、减少皮片并发症及缩短住院时间等方面具有明显优势,值得临床推荐。Objective To compare the application of continuous negative pressure wound therapy and conventional packing and pressure bandage in medium thick skin transplantation of difficult to fix wounds.Methods 96 patients who underwent medium thick skin transplantation of difficult to fix wounds in Suizhou Hospital Affiliated to Hubei Medical College from March 2019 to March 2020 were divided into two groups according to whether the patients were treated with contimuous negative pressure wound therapy.48 patients in the control group were treated with conventional packaging and pressure bandage,and 48 pa-tients in the observation group were treated with continuous negative pressure wound therapy.The levels of white blood cell(WBC),C-reactive protein(CRP),skin graft survival area,skin graft survival ratio,skin hematoma ratio,length of hospital stay and incidence of complications were compared between the two groups.Results The levels of W BC and CRP in the two groups at 7 and 14 days after treatment were sig-nifeantly lower than those before treatment(P<0.05);The levels of WBC and CRP in the observation group were significantly lower than those in the control groupat 7 and 14 days after treatment(P<0.05);The survival area and survival ratio of skin graft in the observation group were significantly higher than those in the control group(P<0.05);The area and ratio of skin hematoma in the observation group were signifi-cantly lower than those in the control group(P<0.05);The hospital stay in the observation group was significantly shorter than that in the control group(t=10.472.P=0.001);The incidence of skin graft com-plications in the observation group was significantly lower than that in the control group(2.08%vs 12.50%)(χ^(2)=10.174,P=0.015).Conclusions Continuous negative pressure wound in medium thickness skin transplantation of difficult to fix wound has obv ious advantages in improving the survival area of skin graft,reducing skin graft complications and shortening hospital stay,which is worthy of clinical reeommendat

关 键 词：皮肤移植 负压伤口疗法 创面愈合 

分 类 号：R622[医药卫生—整形外科]