诱导膜技术全厚皮片移植固定治疗儿童下肢缺损创面  

The induced membrane technique combined with full-thickness skin graft fixation for treatment of defect wounds of lower limbs in children

作　　者：吕战虎 吐尔洪·努尔敦 满时峰 郑飞[1] 欧阳国新 汤志辉[1] LU Zhan-hu;Tuerhong·Nuerdun;MAN Shi-feng;ZHENG Fei;OU-YANG Guo-xin;TANG Zhi-hui(Dept of Orthopaedics,the First Division Hospital of Xinjiang Production and Construction Corps,Akesu,Xinjiang 843000,China)

机构地区：[1]新疆生产建设兵团第一师医院骨科,新疆阿克苏843000

出　　处：《临床骨科杂志》2023年第2期207-210,共4页Journal of Clinical Orthopaedics

基　　金：兵团财政科技计划资助项目(编号:2021DB021)。

摘　　要：目的 探讨诱导膜技术全厚皮片移植固定治疗儿童下肢缺损创面的临床疗效。方法 采用诱导膜技术全厚皮片移植固定治疗15例下肢缺损创面患儿。入院后急诊一期彻底清创后固定,骨水泥填塞,骨水泥表面钻孔,碘伏油纱包加压固定;二期取出骨水泥行全厚皮片移植及碘伏油纱包加压固定。结果 患儿均获得随访,时间4个月~3年。末次随访时,创面愈合良好,未见窦道、渗出、破溃;7例部分供皮区及皮片移植区存在不同程度增生性瘢痕形成;15例髋、膝、踝关节功能均恢复良好,无跛行、异常步态;未见骨折不愈合、延迟愈合、畸形愈合及骨髓炎、骨生长区损伤、骨水泥毒性反应等并发症的发生。结论 采用诱导膜技术全厚皮片移植固定治疗儿童下肢缺损创面,具有抗感染能力强、创面愈合良好、并发症少的优点。Objective To investigate the clinical effect of induced membrane technique combined with full-thickness skin graft fixation for treatment of defect wounds of lower limbs in children.Methods The 15 children with lower limb defects were treated by induced membrane technique and full-thickness skin graft fixation.After admission,the first stage was performed with the emergency department thorough debridement and fixation,bone cement filling,drilling through the surface of bone cement,and iodophor gauze compression and fixation protection;in the second stage,the bone cement was taken out and the full-thickness skin graft was transplanted,the iodophor gauze was wrapped for pressure fixation and protection.Results All children patients were followed up from 4 months to 3 years.At the last follow-up,the wound healed well;no sinus,exudation,ulceration occurred,and scar formation occurred in some donor sites.Different degree scar formation were found in part of the skin donor area and skin graft area in 7 children.The function of hip,knee and ankle recovered well in 15 cases,without lameness or abnormal gait.No complications such as nonunion,delayed union,malunion,osteomyelitis,bone growing area injury and bone cement toxicity were observed.Conclusions The treatment of children′s lower limb defect wound with induced membrane technique combined with full-thickness skin graft fixation have many advantages,such as strong anti-infection ability,good wound healing,fewer complications.

关 键 词：下肢缺损创面 诱导膜技术 碘伏油纱包 全厚皮片 

分 类 号：R658.3[医药卫生—外科学] R622.1[医药卫生—临床医学]