摘要
目的探讨创伤致大面积皮肤缺损患者采用祛腐生肌膏配合岛状邮票植皮的治疗效果。方法选取收治的暴力外伤致大面积皮肤挫伤、脱套伤患者30例,均在一期清创缝合后出现大面积皮肤坏死,创面感染。将患者随机分成观察组和对照组。观察组采用祛腐生肌膏换药,待肉芽组织覆盖创面后进行岛状邮票植皮,随后继续采用生肌膏换药。对照组行负压封闭引流(VSD)后常规清创换药,待肉芽组织覆盖创面后行邮票植皮,之后继续常规换药。观察2组患者植皮准备时间、植皮成活时间、新生上皮出现时间、创面愈合时间。结果观察组采用祛腐生肌膏配合岛状邮票植皮后,植皮成活时间、新生上皮生长速度、创面愈合时间均快于对照组。随访时患者创面均愈合,骨与肌腱的裸露区域得以良好覆盖,其中1例创伤严重,愈合较慢,经3个月换药创面最终均愈合。结论采用祛腐生肌膏换药,肉芽组织生长迅速,植皮准备时间短,配合岛状邮票植皮能提高植皮成活率,促进创面愈合。
Objective To investigate the therapeutic effect of Qufu Shengji Ointment combined with island-shaped stamp skin-grafting in patients with large area skin defect.Methods Thirty patients with large-scale skin contusion and skin degloving injury caused by violent trauma were selected,and had large skin necrosis and wound infection after debridement and suture in first stage.Patients were randomly divided into observation and control groups.The observation group used the Qufu Shengji Ointment for dressing change.After the granulation tissue covered the wound surface,the island-shaped stamp skin graft was carried out,and then the Qufu Shengji Ointment continued for dressing change.The control group underwent negative pressure closed drainage(VSD),and then routine debridement dressing was conducted,and then the conventional dressing continued.The skin preparation time,skin graft survival time,neonatal epithelial appearance time and wound healing time of the two groups were observed.Results After the skin grafting combined with the island stamp,the skin graft survival time and survival time of skin-grafting,growth rate of new epithelium and wound healing time were faster than the control group.At the time of follow-up,the wounds healed and the exposed areas of the bones and tendons were well covered.One patient had severe wound and healed slowly.After 3 months,the wound was finally healed.Conclusion Qufu Shengji Ointment can promote granulation tissue growing,and shorten preparation time of skin grafting,improve the survival rate of skin graft and promote wound healing.
作者
张磊
沈金虎
杨六中
张镇
李朝顶
罗仲伟
程飞
ZHANG Lei;SHEN Jinhu;YANG Liuzhong;ZHANG Zhen;LI Chaoding;LUO Zhongwei;CHENG Fei(Xuzhou Hospital of Traditional Chinese Medicine,Xuzhou,Jiangsu,221000;Nanjing University of Traditional Chinese Medicine,Nanjing,Jiangsu,210000)
出处
《实用临床医药杂志》
CAS
2020年第2期38-40,44,共4页
Journal of Clinical Medicine in Practice
基金
江苏省中医药局科技项目(YB201828)
关键词
大面积创面
祛腐生肌膏
岛状邮票植皮
负压封闭引流
large area wound
Qufu Shengji Ointment
island-shaped stamp skin-grafting
vacuum sealing drainage
