自体皮移植联合VSD技术修复糖尿病足难治性溃疡创面疗效分析  

Efficacy Analysis of Autologous Skin Grafting Combined with VSD in the Repair of Refractory Diabetic Foot Ulcer Wounds

作　　者：张磊 李敏[1] 王立波[1] ZHANG Lei;LI Min;WANG Libo(Department of Traumatic Hand Surgery,Daqing Longnan Hospital,Daqing 163453,Heilongjiang,China)

机构地区：[1]大庆龙南医院创伤手外科,黑龙江大庆163453

出　　处：《中国美容医学》2024年第7期115-118,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究自体皮移植联合封闭负压引流(Vacuum sealing drainage,VSD)技术对糖尿病足难治性溃疡创面的修复效果。方法:选取笔者医院2019年1月-2022年10月收治的60例糖尿病足难治性溃疡患者为研究对象,按照随机数字表法将其分为对照组和观察组,分别为29例、31例,对照组给予自体皮移植治疗,观察组实施自体皮移植联合VSD技术治疗,统计比较两组患者临床疗效、植皮存活率、创面愈合时间、温哥华瘢痕评分量表(Vancouver scar scale,VSS)评分、血清基质金属蛋白酶(Matrix metalloproteinases,MMP)水平及不良事件发生情况。结果:治疗2周后,观察组临床总有效率为90.32%,高于对照组的68.97%(P<0.05);观察组植皮存活率高于对照组,创面愈合时间短于对照组(P<0.05);治疗1周后,观察组MMP-2、MMP-9水平低于对照组(P<0.05);观察组复发1例,对照组复发3例,坏疽2例,再次手术1例,两组比较差异有统计学意义(P<0.05)。观察组治疗后3、6个月的VSS评分低于对照组(P<0.05)。结论:采用自体皮移植联合VSD技术治疗糖尿病足难治性溃疡创面,能提高植皮存活率,加快溃疡愈合,降低MMP-2、MMP-9表达水平,且不良事件发生率低,疗效确切。Objective The aim of this study was to investigate the repair effect of autologous skin grafting combined with vacuum sealing drainage(VSD)on refractory diabetic foot ulcer wounds.Methods A total of 60 patients with refractory diabetic foot ulcer who were treated in the author's hospital from January 2019 to October 2022 were selected as the research subjects.They were divided into the control group(29 cases)and the observation group(31 cases)using the random number table method.The control group was treated with autologous skin grafting,and the observation group was treated with autologous skin grafting combined with VSD.The clinical effcacy,skin graft survival rate,wound healing time,Vancouver Scar Scale(VSS)score,matrix metalloproteinase(MMP)level,and incidence rates of adverse events of patients between the two groups were statistically compared.Results After 2 weeks of treatment,the total clinical effective rate of the observation group was 90.32%,which was higher than 68.97%of the control group(P<0.05).The survival rate of skin grafting in the observation group was higher than that in the control group,and the wound healing time was shorter than that in the control group(P<0.05).After 1 week of treatment,the levels of MMP-2 and MMP-9 in the observation group were lower than those in the control group(P<0.05).There was 1 case of recurrence in the observation group,3 cases of recurrence,2 cases of gangrene and 1 case of reoperation in the control group,and the difference was statistically significant(P<0.05).The VSS scores of the observation group at 3 and 6 months after treatment were lower than those of the control group(P<0.05).Conclusion Autologous skin grafting combined with VSD can achieve good repair effect on refractory diabetic foot ulcer wounds.It can improve the survival rate of skin grafts,accelerate ulcer wounds healing and lower the expression levels of MMP-2 and MMP-9,with a low incidence of adverse events.

关 键 词：糖尿病足 难治性溃疡 自体皮移植 封闭负压引流技术 修复 

分 类 号：R473.6[医药卫生—护理学]