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抗菌浸渍敷料联合负压伤口治疗可提高中厚皮片移植成功率:一种简单有效的技术。

Antimicrobial-impregnated dressing combined with negative-pressure wound therapy increases split-thickness skin graft engraftment: a simple effective technique.

作者信息

Wu Cheng-Chun, Chew Khong-Yik, Chen Chien-Chang, Kuo Yur-Ren

机构信息

Cheng-Chun Wu, MD, is a Surgeon; Khong-Yik Chew, MD, is a Surgeon; Chien-Chang Chen, MD, is a Surgeon; and Yur-Ren Kuo, MD, PhD, FACS, is Chief of Surgery and Professor of Plastic Surgery, all at the Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Gueishan, Taoyuan, Taiwan. The authors have disclosed that they have no financial relationships related to this article.

出版信息

Adv Skin Wound Care. 2015 Jan;28(1):21-7. doi: 10.1097/01.ASW.0000459038.81701.fb.

Abstract

OBJECTIVE

Immobilization and adequate surface contact to wounds are critical for skin graft take. Techniques such as the tie-over dressing, cotton bolster, and vacuum-assisted closure are used to address this, but each has its limitations. This study is designed to assess the effect of antimicrobial-impregnated dressing (AMD) combined with negative-pressure wound therapy (NPWT) on skin graft survival.

DESIGN

Retrospective case-control study

PARTICIPANTS

: Patients with chronic or contaminated wounds treated with split-thickness skin graft. A broad spectrum of wounds was included, from causes such as trauma, burns, chronic diabetic ulcers, and infection.

INTERVENTIONS

Antimicrobial-impregnated dressing, which contains 0.2% polyhexamethylene biguanide, with NPWT MAIN OUTCOME MEASURE:: Success of skin graft

MAIN RESULTS

: In the AMD group, all skin grafts achieved 100% take without secondary intervention. No infection or graft failure was observed in any patients, and no complications, such as hematoma or seroma formation, were noted, although in the control group partial loss of skin grafts was noted in 3 patients. Infection and inadequate immobilization were thought to be the main reasons. There were no hematoma or seroma formations in the control group.

CONCLUSION

Use of an AMD dressing with NPWT after split-thickness skin grafting can be an effective method to ensure good graft to wound contact and enhances skin graft take in chronic and contaminated wounds.

摘要

目的

伤口的固定及与创面的充分表面接触对于皮肤移植的成功至关重要。诸如打包加压包扎、棉垫支撑及负压封闭引流等技术被用于解决这一问题,但每种技术都有其局限性。本研究旨在评估含抗菌成分敷料(AMD)联合负压伤口治疗(NPWT)对皮肤移植存活的影响。

设计

回顾性病例对照研究

参与者

接受中厚皮片移植治疗的慢性或污染伤口患者。纳入了多种伤口,包括创伤、烧伤、慢性糖尿病溃疡及感染等原因导致的伤口。

干预措施

含0.2%聚六亚甲基双胍的抗菌成分敷料联合NPWT

主要观察指标

皮肤移植成功

主要结果

在AMD组,所有皮肤移植均100%成功,无需二次干预。所有患者均未观察到感染或移植失败,也未发现血肿或血清肿形成等并发症,尽管在对照组有3例患者出现了部分皮肤移植失败。感染及固定不充分被认为是主要原因。对照组未出现血肿或血清肿形成。

结论

中厚皮片移植后使用含AMD敷料联合NPWT可成为确保移植皮片与伤口良好接触并提高慢性及污染伤口皮肤移植成功率的有效方法。

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