论著 Original Article

负压封闭引流与传统加压包扎法在治疗前臂皮肤脱套伤中的临床效果

Published at: 2017年第37卷第9期

王伟 1 , 潘朝晖 2 , 薛山 2 , 赵玉祥 2
1 潍坊医学院临床学院,山东 潍坊 261000
2 解放军89医院骨病科,山东 潍坊 261021
通讯作者 朝晖 潘 Email: prub003@163.com
DOI: 10.3978/j.issn.2095-6959.2017.09.023
基金:

摘要

目的:对比皮肤原位回植结合负压封闭引流术(vacuum sealing drainage,VSD)和皮肤原位回植结合加压包扎法治疗前臂皮肤脱套伤的临床效果。方法:回顾2003年1月至2017年1月急诊采用皮肤原位回植结合VSD技术和皮肤原位回植结合加压包扎治疗80例前臂皮肤脱套伤的病例,其中男48例,女32例,年龄16~71(中位38)岁。受伤原因:交通事故12例,机器挤伤68例。脱套面积(271.2±60.4) cm2。40例接受VSD结合皮肤原位回植术为研究组,40例接受传统加压包扎结合皮肤原位回植术为对照组。对比两组植皮成活率、创面感染率、皮下血肿发生率、手术用时、住院时间、换药次数及二次手术率。结果:研究组术后回植皮肤成活率(89.0%±9.2%)高于对照组的(72.6%±16.0%),研究组的住院时间和换药次数少于对照组,差异均有统计学意义(P<0.05)。研究组的感染率、皮下血肿发生率、二次手术修复率低于对照组,差异均有统计学意义(P<0.05)。结论:急诊采用皮肤原位回植结合VSD负压吸引技术治疗前臂皮肤脱套伤相较于传统的皮肤原位回植结合加压包扎法,可以提高回植皮肤成活率,减少皮肤创面感染和产生皮下血肿率,降低二期手术修复率,缩短住院时间和换药次数。


Clinical efficacy of vacuum sealing drainage and traditional pressure dressing technology in the treatment of the degloving injury of forearm

Abstract

Objective: To compare the Clinical efficacy of vacuum sealing drainage (VSD) and traditional pressure dressing technology respectively combining with skin in situ replantation for the treatment of skin degloving injury of forearm. Methods: From Jan. 2003 to Jan. 2017, 90 patients of the degloving injury of forearm were treated by the method of VSD and traditional pressure dressing technology respectively combining with skin in situ replantation. There were 48 male and 32 females, aged 16–71 years (mean 38 years). Twelve cases were caused by traffic accidents, 68 cases by machine injuries. The study group included 40 patients who underwent VSD combining with skin in situ replantation operation, the other 40 patients accepted traditional pressure dressing technology combining with skin in situ replantation operation were the control group. The survival rate of skin graft, the length of hospital stay, the time of operation, the reoperation rate, the number of dressing change, the rate of wound infection and subcutaneous hematoma were compared between the two groups. Results: After the one-stage operation, the survival rate of skin of study group is 89.0%±9.2% and the control group is 72.6%±16.0%; the hospitalization time and the number of dressing change of study group were significantly shorter than those of the control group, the differences were all statistically significant (P<0.05). The reoperation rate and the rate of wound infection and subcutaneous hematoma of study group were lower than that in the control group, the differences were all statistically significant (P<0.05). Conclusion: The one-stage operation that uses skin in situ replantation combining with VSD technical to repair the degloving injury of forearm comparing to pressure dressing method can increase the survival rate of skin graft and reduce the incidence of wound infection and subcutaneous hematoma . This method could reduce the reoperation rate and it also could reduce the hospitalization time and the number of dressing change.


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引用

引用本文: 伟 王, 朝晖 潘, 山 薛, 玉祥 赵. 负压封闭引流与传统加压包扎法在治疗前臂皮肤脱套伤中的临床效果[J]. 临床与病理杂志, 2017, 37(9): 1904-1910.
Cite this article as: WANG Wei, PAN Zhaohui, XUE Shan, ZHAO Yuxiang . Clinical efficacy of vacuum sealing drainage and traditional pressure dressing technology in the treatment of the degloving injury of forearm[J]. Journal of Clinical and Pathological Research, 2017, 37(9): 1904-1910.