Elwood E T, Bolitho D G
Department of Surgery, Emory University School of Medicine, Atlanta, GA, USA.
Ann Plast Surg. 2001 Jan;46(1):49-51. doi: 10.1097/00000637-200101000-00010.
Negative-pressure dressings have been used in the treatment of a variety of open wounds, and as a bolster for skin grafts. The benefits of these dressings include increased oxygen tension in the wound, decreased bacterial counts, increased granulation formation, and the prevention of shear force on wounds. Also, by virtue of the diminished need for daily dressing changes, there are the additional advantages of enhancing patient comfort, decreasing nursing work, and diminished cost of wound care. Hidradenitis suppurativa (HS) is a chronic infection of the apocrine sweat glands. Treatment options range from oral isotretinoin to radical excision. Wound closure may be achieved by secondary intention, skin grafting, or flap closure. Complications may still arise and include disease progression and squamous cell carcinoma. Radical excision yields the best results in terms of disease eradication. The authors describe using the negative-pressure dressing in two cases of bilateral axillary HS to secure skin grafts firmly to the wound bed after radical excision of all involved tissues. Patient comfort and acceptance was high, and skin graft take was excellent. The dressings themselves are simple to apply and are highly effective.
负压敷料已被用于多种开放性伤口的治疗,并作为皮肤移植的支撑物。这些敷料的益处包括增加伤口处的氧张力、减少细菌数量、增加肉芽组织形成以及防止伤口受到剪切力。此外,由于减少了每日换药的需求,还具有提高患者舒适度、减少护理工作以及降低伤口护理成本等额外优点。化脓性汗腺炎(HS)是顶泌汗腺的一种慢性感染。治疗选择范围从口服异维A酸到根治性切除。伤口闭合可通过二期愈合、皮肤移植或皮瓣闭合来实现。并发症仍可能出现,包括疾病进展和鳞状细胞癌。就疾病根除而言,根治性切除效果最佳。作者描述了在两例双侧腋窝HS病例中,在彻底切除所有受累组织后,使用负压敷料将皮肤移植片牢固地固定于创面。患者舒适度和接受度很高,皮肤移植片成活情况良好。这些敷料本身应用简单且效果显著。