摘要
目的:探讨负压封闭引流技术(Vacuum sealing drainage,VSD)结合肌瓣转移游离植皮修复面部难愈性创面的效果。方法:选择2014年1月-2017年6月收入笔者医院的120例面部难愈性创面患者为研究对象,根据入组时间编号并随机分为研究组(60例)、对照组(60例)。对照组患者给予负压封闭引流技术治疗后依据创面情况采用缝合或继续负压治疗,至创面愈合;研究组患者给予负压封闭引流技术结合肌瓣转移游离植皮治疗。比较两组患者的治疗效果、并发症发生情况、红期进入时间、创面愈合时间、创面愈合率、治疗期间感染发生率及疼痛情况。结果:研究组患者的总有效率、14d创面愈合率显著优于对照组,差异有统计学意义(P<0.05)。研究组患者的红期进入时间、创面愈合时间、治疗期间感染发生率显著低于对照组(P<0.05)。两组患者经治疗后VAS评分显著降低,其中观察组患者VAS评分在术后1~7d的改善程度均优于对照组(P<0.05)。研究组患者的创面出血发生率显著低于对照组(P<0.05),而研究组患者的皮肤过敏、湿疹发生率与对照组比较差异无统计学意义(P>0.05)。结论:负压封闭引流技术结合肌瓣转移游离植皮修复面部难愈性创面效果显著,能够显著提高治疗效果,促进创面愈合,减少感染发生率,减轻患者疼痛,降低并发症发生率,值得临床推广应用。
Objective To explore the effect of vacuum sealing drainage combined with muscle flap transfer and free skin grafting in the repair of facial refractory wounds.Methods 120 cases of facial refractory wounds in our hospital from January 2014 to June 2017 were selected and divided into the study group(60 cases)and the control group(60 cases)according to the number of entry time.The patients in the control group were treated with vacuum sealing drainage technology,and then sutured,or continued vacuum treatment according to the condition of the wound until the wound healed.And the patients in the study group were treated with VSD and muscle flap transfer free skin grafting.The treatment effect,complications,erythrocyte entry time,wound healing time,wound healing rate,incidence of infection and pain during treatment were compared between the two groups.Results The total effective rate and 14 day wound healing rate of the patients in the study group were significantly higher than those in the control group,the difference were statistically significant(P<0.05).The red phase entry time,wound healing time and infection rate in the study group were significantly lower than those in the control group(P<0.05).After treatment,the VAS score of the patients in the observation group was significantly lower than that in the control group(P<0.05).The incidence of bleeding was significantly lower in the study group than that in the control group(P<0.05).But there was no significant difference in the incidence of skin allergy and eczema between the study group and the control group(P>0.05).Conclusion VSD combined with muscle flap transfer free skin graft for the treatment of facial wound is effective and it can significantly improve the treatment effect,promote wound healing,reduce the incidence of infection,reduce the pain of patients,reduce the incidence of complications,worthy of clinical application.
作者
孟红阳
杨新蕾
张新合
高优
MENG Hong-yang;YANG Xin-lei;ZHANG Xin-he;GAO You(Department of Burn Plastic Surgery,174 Hospital of PLA,Xiamen 361003,Fujian,China)
出处
《中国美容医学》
CAS
2019年第12期22-26,共5页
Chinese Journal of Aesthetic Medicine
基金
福建省科技计划项目(编号:18FQN2015005)
关键词
难愈性创面
负压封闭引流技术
肌瓣移植
植皮
面部
创面修复
refractory wound
vacuum sealing drainage
muscle flap transplantation
skin grafting
face
wound repair
