摘要
目的:探讨替尔皮片联合负压封闭引流技术(VSD)在治疗颈部巨大恶性肿瘤术后缺损创面中的应用。方法:对19例侵犯皮肤的颈部巨大恶性肿瘤行肿瘤根治性手术,应用VSD覆盖创面。术后给予持续6.65～7.98mm Hg(1mm Hg=0.133kPa)负压引流72h,改用间歇负压机治疗:负压治疗5min,间歇2min。术后7～10d拆除VSD,肉芽组织生长良好的创面取大腿替尔皮片植皮术;肉芽组织生长差、颈部重要组织未完全覆盖的创面再次VSD覆盖封闭治疗1周,创面植皮。结果:19例共接受23例次VSD创面治疗,一期手术时间明显缩短。接受VSD治疗后创面肉芽组织生长较快,有效覆盖颈部大血管等重要组织,拆除VSD后可直接观察术部有无感染及肿瘤复发情况。术后1～3周顺利植皮。结论:将VSD联合替尔皮片移植用于颈部巨大肿瘤术后缺损创面的治疗,具有操作简单、损伤小、促进创面愈合等优点,是一种治疗颈部巨大肿瘤术后缺损的有效方法。
Objective： To evaluate the effect of the combined application of dissociate skin flap and vacuum sealing drainage（VSD） for the reparing for defect after surgical management of huge neck neoplasms. Method： Nineteen patients with huge neck malignant tumor involving the skin of the neck were given radical operation, making use of VSD covering the wound surface. After giving 6. 65 -- 7. 98 mm Hg continuous negative pressure drainage for 72 h, the patients turned to be treated by intermittent negative pressure therapy with 2 rain free inter- val after each treatment period for 5rain. After dismantling the VSD at 7th to 10th day postoperatively, the good wounds covered by granulation tissue were treated by the skin graft operation with dissociate skin flap from thighs; as for the wounds of which the granulation tissue didn＇t grow well and important cervical tissues was not fully covered by the granulation tissue, VSD was applied again for 1 week, followed by the skin graft operation. Result：Nineteen patients have received a total of 23 times of VSD wound treatment, one-stage operation time was significantly shortened. The granulation tissue grew faster on the wound after VSD treatment, and the important cervical tissues such as great vessels could be well covered. The infection and tumor recurrence were observed di- rectly after dismantling the VSD. The skin graft transplation would be performed after 1 -- 3 weeks. Conclusion： The treatment by vacuum sealing drainage combined with skin graft for surgical wounds of huge neck tumor post- operatively has the advantages of simple operation, little injury and promotion of the wound healing, which is an effective way for treatment of neck skin defect by surgrical operation for the huge tumor.
出处
《临床耳鼻咽喉头颈外科杂志》
CAS
CSCD
北大核心
2012年第24期1113-1115,共3页
Journal of Clinical Otorhinolaryngology Head And Neck Surgery
关键词
颈部肿瘤
修复外科手术
负压封闭引流技术
neck neoplasms
reconstructive surgical procedures
vacuum sealing drainage
