邮票植皮术联合VSD在大面积皮肤撕脱伤创面封闭治疗中的应用研究  

Application study of stamp skin grafting combined with VSD in closure treatment of large area skin avulsion wounds

作　　者：石英光 李士民 周树萍 常超楠 邢新风 SHI Yingguang;LI Shimin;ZHOU Shuping;CHANG Chaonan;XING Xinfeng(Burn and Plastic Surgery Department,988th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China,Zhengzhou,Henan 450000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八八医院烧伤整形科,河南郑州450000

出　　处：《中国医学工程》2025年第2期74-78,共5页China Medical Engineering

基　　金：河南省医学科技攻关项目(LHGJ202102401)。

摘　　要：目的 观察邮票植皮术联合常规负压封闭引流术(VSD)在大面积皮肤撕脱伤创面封闭治疗中的应用效果。方法 该研究为前瞻性研究,选择2021年1月至2023年6月期间中国人民解放军联勤保障部队第九八八医院收治的90例大面积皮肤撕脱伤患者为研究对象,按照入院先后顺序收集患者数据后,依据计算机随机分组将其分为常规组(45例)和试验组(45例),常规组实施VSD治疗,试验组在常规组基础上采用邮票植皮术辅助治疗,比较两组患者的治疗、康复情况,皮瓣成活情况,炎症反应,治疗有效率及并发症发生情况。结果 在不同治疗方案下,试验组的换药次数、抗感染治疗时间、肉芽生长时间、创面愈合时间、住院时间分别为(5.15±1.29)次、(8.41±1.38) d、(8.29±1.47) d、(20.33±5.15) d、(21.26±5.47)d,均低于常规组[(7.75±1.82)次、(10.36±2.23)d、(10.25±2.37)d、(23.11±5.25)d、(24.49±5.36)d](P<0.05);试验组的Ⅰ期成活率71.11%(32/45)高于常规组44.44%(20/45)(P<0.05);试验组的细胞间黏附分子-1(ICAM-1)水平低于常规组[(135.25±20.37)μg/L vs.(150.43±20.46)μg/L](P<0.05),促红细胞生成素(EPO)高于常规组[(26.44±5.25) IU/L vs.(23.12±5.33) IU/L](P<0.05);试验组的治疗有效率84.44%(38/45)高于常规组62.22%(28/45),并发症发生率8.89%(4/45)低于常规组26.67%(12/45)(P<0.05)。结论 邮票植皮术联合VSD能有效改善大面积皮肤撕脱伤患者的治疗及康复情况,对提升皮瓣成活率、减轻炎症反应、增强治疗效果并降低术后并发症发生风险均有积极意义。【Objective】 To observe the application effect of stamp skin grafting in the sealing treatment of large area skin avulsion wounds.【Methods】 This study is a prospective study,selecting 90 patients with extensive skin avulsion injuries admitted between January 2021 and June 2023 as the study subjects.After collecting patient data in the order of admission,they were randomly divided into a conventional group(45 cases) and an experimental group(45 cases) based on computer randomization.The conventional group received conventional vacuum sealing drainage(VSD) treatment,while the experimental group received stamp skin grafting as an auxiliary treatment.The treatment and rehabilitation status,survival status of skin flaps,inflammatory response,treatment effectiveness rate,and incidence of complications of the two groups of patients were compared.【Results】 Under different treatment plans,the number of dressing changes,anti infection treatment time,granulation growth time,wound healing time,and hospitalization time in the experimental group were 5.15±1.29 times,8.41±1.38 days,8.29±1.47 days,20.33±5.15 days,and 21.26±5.47 days,lower than the conventional group(7.75±1.82 times,10.36±2.23 days,10.25±2.37 days,23.11±5.25 days,and 24.49±5.36 days)(P<0.05).The Phase I survival rate of the experimental group was 71.11%(32/45),higher than the conventional group [44.44%(20/45)](P<0.05).ICAM-1 of the experimental group(135.25±20.37 μg/L) was lower than the conventional group(150.43±20.46 μg/L),and EPO(26.44±5.25 IU/L) was higher than the conventional group(23.12±5.33 IU/L)(P<0.05).The treatment effectiveness rate of the experimental group was 84.44%(38/45),higher than that of the conventional group [62.22%(28/45],and the incidence of complications of the experimental group [8.89%(4/45)] was lower than that of the conventional group [26.67%(12/45)](P<0.05).【Conclusion】 The combination of stamp skin grafting and VSD can effectively improve the treatment and rehabilitation of patients with large-scale sk

关 键 词：大面积皮肤撕脱伤 邮票植皮术 负压封闭引流术 皮瓣成活 术后并发症 

分 类 号：R641[医药卫生—外科学]