Department of Surgery, Sapucaí Valley University (UNIVÁS), Pouso Alegre, MG, Brazil.
World J Surg. 2013 Jun;37(6):1438-45. doi: 10.1007/s00268-013-1975-z.
Disability and pain were assessed in patients with venous leg ulcers treated with split-thickness skin grafts to evaluate to what extent skin grafting improves functional status in this population.
A prospective, nonrandomized, multicenter case-control study was conducted from July 2008 to December 2010 in two hospitals in Brazil. One hundred patients with venous leg ulcers were divided into two treatment groups of 50 patients each: the control group (conservative treatment) and the surgery group (skin grafting). Patients were assessed at baseline (day 0) and on days 30, 90, and 180. Disability was measured with the Disability Index of the Health Assessment Questionnaire (HAQ-DI). The visual analog scale (VAS) and McGill Pain Questionnaire (MPQ) were used to assess pain.
Surgery group patients reported significantly lower (p = 0.0001) overall HAQ-DI scores (lower disability levels) 180 days postoperatively (HAQ-DI = 0.18) compared with baseline (HAQ-DI = 2.65); mean overall HAQ-DI scores for control patients was 1.70 on day 180, with a significant difference between groups (p = 0.0001). The surgery group showed significant improvement on all HAQ-DI categories and reported significantly lower pain intensity (VAS pain scores) on days 30, 90, and 180 compared with controls (p = 0.0001). The MPQ was used to assess the sensory, affective, evaluative, and miscellaneous dimensions of pain in the two groups; there were significant differences between groups on days 30, 90, and 180 (p = 0.0001).
Patients with venous leg ulcers treated with split-thickness skin grafts showed improvement in functional status compared with controls.
本研究评估了接受断层皮片移植治疗的静脉性下肢溃疡患者的残疾和疼痛情况，以明确皮片移植治疗在多大程度上改善了该人群的功能状态。
本研究为 2008 年 7 月至 2010 年 12 月在巴西两家医院开展的一项前瞻性、非随机、多中心病例对照研究。100 例静脉性下肢溃疡患者分为两组，每组 50 例：对照组（保守治疗）和手术组（皮片移植）。患者在基线（第 0 天）和第 30、90 和 180 天进行评估。采用健康评估问卷残疾指数（HAQ-DI）评估残疾情况。采用视觉模拟评分法（VAS）和麦吉尔疼痛问卷（MPQ）评估疼痛。
术后 180 天，手术组患者的 HAQ-DI 总分（较低的残疾水平）显著低于基线时（HAQ-DI=2.65）（p=0.0001）（HAQ-DI=0.18）；对照组患者在第 180 天的 HAQ-DI 总分为 1.70，两组间差异有统计学意义（p=0.0001）。手术组在所有 HAQ-DI 类别中均有显著改善，与对照组相比，手术组在第 30、90 和 180 天的疼痛强度（VAS 评分）显著降低（p=0.0001）。采用 MPQ 评估两组患者的感觉、情感、评价和杂项疼痛维度；两组在第 30、90 和 180 天的各维度差异均有统计学意义（p=0.0001）。
与对照组相比，接受断层皮片移植治疗的静脉性下肢溃疡患者的功能状态得到改善。
