打包植皮与不打包植皮修复手部岛状皮瓣供区创面的疗效比较  

Comparison of the effect of skin grafting with and without packing in repairing the wound of hand island flap donor site

作　　者：许涛 顾加祥 张乃臣 刘宏君 XU Tao;GU Jiaxiang;ZHANG Naichen(Department of Hand and Foot Surgery,Clinical Medical College of Yangzhou University,Northern Jiangsu People's Hospital,Yangzhou,Jiangsu,225001,China)

机构地区：[1]扬州大学临床医学院,江苏省苏北人民医院手足外科,江苏扬州225001

出　　处：《实用手外科杂志》2023年第1期47-50,共4页Journal of Practical Hand Surgery

摘　　要：目的比较分析打包植皮与不打包植皮法修复手部岛状皮瓣移植供区创面的手术方法和临床疗效。方法回顾性分析2015年7月-2021年7月收治的80例手部岛状皮瓣植皮覆盖供区患者的临床资料,其中40例采用传统打包植皮的方法,为A组;另40例采用改良的不打包植皮方法,为B组。通过手术时长及住院时长、植皮的成活率、末次随访时的感觉及运动功能恢复情况及植皮外观(是否存在瘢痕增生及局部凹陷等)和患者的满意度等维度对两组患者进行比较评价。结果两组的手术时长及住院时长比较,P<0.001,差异有明显统计学意义,B组明显优于A组;A组有1例发生部分坏死,成活率为97.5%,B组40例全部一期成活,成活率为100%,差异无统计学意义(P>0.05);末次随访时感觉和手指关节运动功能恢复情况比较,差异无统计学意义(P>0.05);末次随访时对植皮外观优良率评定,B组明显优于A组,差异有统计学意义(P<0.05)。结论不打包植皮修复手部岛状皮瓣供区创面,简化了手术步骤,减少了手术及住院时间,同时成活率和功能与传统打包植皮方法相当,在外观及满意度方面明显优于传统打包植皮,是一种较为实用的植皮方法。Objective To investigate the surgical method and clinical effect of packaged skin grafting and non packaged skin grafting in repairing the donor wound of hand island flap.Methods The patients who received island flap with skin grafting to cover the donor area in our hospital from July 2015 to July 2021 were selected,of which 40 cases were treated with traditional packaging skin grafting,group A,and the other 40 cases were treated with improved non packaging skin grafting,group B.Two groups were evaluated and compared by the length of operation and hospitalization,the survival rate of skin graft,the recovery of sensory and motor function at the last follow-up,the appearance of skin graft(whether there was scar hyperplasia and local depression,etc.)and the satisfaction of patients.Results The operation time and hospitalization time of two groups were significantly different(P<0.001).Group B was significantly better than group A.One case in group A had partial necrosis,and the survival rate was 97.5%.All 40 cases in group B survived in one stage,and the survival rate was 100%.P>0.05,there was no significant difference.At the last follow-up,there was no significant difference in the recovery of sensory and finger joint motor function(P>0.05).At the last follow-up,the excellent and good rate of skin graft appearance was evaluated(P<0.05).Group B was significantly better than group A.Conclusion Repairing the wound of hand island flap donor area with non packaging skin grafting simplifies the operation steps and reduces the operation and hospital stay.At the same time,the survival rate and function are equivalent to those of traditional packaging skin grafting,which is obviously superior to traditional packaging skin grafting in appearance and satisfaction.It is a more practical skin grafting method.

关 键 词：植皮 皮瓣供区 疗效对比 

分 类 号：R658.2[医药卫生—外科学]