Zhang Longcheng, Quan Chaokun, Jiang Jing, Lin Xinran, Tang Zhengyi, Lin Wenbiao, Lu Sheng, Wei Ganguan, Chen Haoying, Hu Lishan, Zhao Zhen, Li Yongling, Ren Yi
Department of Otorhinolaryngology Head and Neck Surgery, No. 303 Hospital of PLA, Nanning 530021, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2012 Dec;26(24):1113-5.
To evaluate the effect of the combined application of dissociate skin flap and vacuum sealing drainage (VSD) for the repairing for defect after surgical management of huge neck neoplasms.
Nineteen patients with huge neck malignant tumor involving the skin of the neck were given radical operation, making use of VSD covering the wound surface. After giving 6.65-7.98 mm Hg continuous negative pressure drainage for 72 h, the patients turned to be treated by intermittent negative pressure therapy with 2 min free interval after each treatment period for 5 min. After dismantling the VSD at 7th to 10th day postoperatively, the good wounds covered by granulation tissue were treated by the skin graft operation with dissociate skin flap from thighs; as for the wounds of which the granulation tissue didn't grow well and important cervical tissues was not fully covered by the granulation tissue, VSD was applied again for 1 week, followed by the skin graft operation.
Nineteen patients have received a total of 23 times of VSD wound treatment, one-stage operation time was significantly shortened. The granulation tissue grew faster on the wound after VSD treatment, and the important cervical tissues such as great vessels could be well covered. The infection and tumor recurrence were observed directly after dismantling the VSD. The skin graft transplantation would be performed after 1-3 weeks.
The treatment by vacuum sealing drainage combined with skin graft for surgical wounds of huge neck tumor postoperatively has the advantages of simple operation, little injury and promotion of the wound healing, which is an effective way for treatment of neck skin defect by surgical operation for the huge tumor.
评估游离皮瓣联合封闭负压引流(VSD)在巨大颈部肿瘤手术切除后创面修复中的应用效果。
19例颈部巨大恶性肿瘤累及颈部皮肤患者行根治性手术,采用VSD覆盖创面。给予6.65 - 7.98 mmHg持续负压引流72小时后,改为间歇性负压治疗,每次治疗5分钟,间隔2分钟。术后7 - 10天拆除VSD,肉芽组织生长良好的创面采用大腿游离皮瓣植皮手术治疗;对于肉芽组织生长不佳且重要颈部组织未被肉芽组织完全覆盖的创面,再次应用VSD 1周,然后行植皮手术。
19例患者共接受VSD创面治疗23次,一期手术时间明显缩短。VSD治疗后创面肉芽组织生长较快,大血管等重要颈部组织能得到良好覆盖。拆除VSD后直接观察有无感染及肿瘤复发情况。1 - 3周后行皮瓣移植术。
封闭负压引流联合植皮治疗巨大颈部肿瘤术后手术创面,具有操作简单、损伤小、促进创面愈合等优点,是巨大肿瘤手术治疗颈部皮肤缺损的有效方法。