改良型富血小板纤维蛋白在面部皮肤癌术后软组织缺损修复中的应用  

Application of A-PRF combined with abdominal full-thickness skin grafting in the repair of soft tissue defects after facial skin cancer surgery

作　　者：李相龙 陈文斌 谢永峰 丁志龙 李雪阳 LI Xianglong;CHEN Wenbin;XIE Yongfeng;DING Zhilong;LI Xueyang(Department of Burns and Plastic Surgery,the Affiliated Huai an Hospital of Xuzhou Medical University,Huai an 223001,China;Department of Hepatobiliary Surgery,the Affiliated Huai an Hospital of Xuzhou Medical University,Huai an 223001,China;Department of Plastic Surgery,Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,China)

机构地区：[1]徐州医科大学附属淮安医院烧伤整形科,江苏淮安223001 [2]徐州医科大学附属淮安医院肝胆外科,江苏淮安223001 [3]徐州医科大学附属医院整形外科,江苏徐州221000

出　　处：《中国肿瘤外科杂志》2022年第6期571-575,共5页Chinese Journal of Surgical Oncology

摘　　要：目的探讨A-PRF联合腹部全厚皮片移植修复面部恶性非黑色素瘤皮肤癌术后软组织缺损中的可行性及疗效。方法选择于2020年1月至2022年6月徐州医科大学附属淮安医院收治的面部皮肤癌术后需行全厚皮片移植患者80例,并根据随机数字表法将患者分为对照组(行皮片移植,外加多层无菌辅料,n=40)和研究组(将A-PRF凝胶覆盖创面后,行皮片移植,外加多层无菌敷料包扎,n=40),比较两组患者术后创面愈合情况,手术后1月及3个月时患者的瘢痕评估(POSAS)得分,两组患者住院期间的平均换药次数、住院时间以及术后至出院前并发症发生率。结果研究组患者术后7 d的皮片存活率高于对照组(P<0.05),研究组患者术后15 d及21 d的创面愈合情况优于对照组(P<0.05),研究组的创面完全愈合时间低于对照组(P<0.05);两组患者术后1个月和3个月的POSAS评分比较,差异具有统计学意义(P<0.05);研究组的平均换药次数、住院时间以及并发症发生率均低于对照组(P<0.05)。结论A-PRF联合腹部全厚皮片移植能够有效地修复面部恶性非黑色素瘤皮肤癌术后软组织缺损,且减少并发症的发生,减短患者的住院时间,值得临床推广应用。Objective To investigate the feasibility and efficacy of PRF combined with abdominal full-thickness skin grafting in the repair of soft tissue defects after facial skin cancer.Methods A total of 80 patients with facial skin cancer who required full-thickness skin grafting after surgery in the Affiliated Huai an Hospital of Xuzhou Medical University from January 2020 to June 2022 were selected and divided into control group and research group equally by the method of random number table.The patients in control group were treated with skin grafting and sterile dressing.And the A-PRF gel skin grafting and sterile dressing were used in research group jointly.The postoperative outcomes of the two groups were compared.The lengths of complete wound healing,the scores of the scar assessment scale(POSAS)after one month(M1)and 3 months(M3)of operation between the two groups were compared.The length of hospital stay,complication rates and average numbers of dressing changes during hospitalization were compared as well.Results The skin graft survival rate of D7 in the research group was higher than that of the control group(P<0.05).There were significant differences on wound healing on D15 and D21 between the two groups(P<0.05).The healing time in research group was lower than that of the control group(P<0.05).The POSAS scores at M1 and M3 were significantly different between the two groups(P<0.05).The patients in research group had fewer average times of dressing changing,shorter length of hospital stay and the lower incidence of complications,compared the patients in control group(P<0.05).Conclusions A-PRF combined with abdominal full-thickness skin grafting can effectively repair soft tissue defects after facial skin cancer surgery,which reduces the occurrence of complications,and shorten the hospitalization time of patients.

关 键 词：改良型富血小板纤维蛋白(A-PRF) 腹部全厚皮片移植 面部皮肤癌 术后软组织缺损修复 

分 类 号：R739.5[医药卫生—肿瘤]