Zhang Fang, Lv Kai-Yang, Qiu Xiao-Chen, Luo Peng-Fei, Zheng Xing-Feng, Zhu Shi-Hui, Xia Zhao-Fan
Department of Burn Surgery, The Second Military Medical University affiliated Changhai Hospital, Shanghai, China; No.73901 Troop of PLA, Shanghai, China.
Department of Burn Surgery, The Second Military Medical University affiliated Changhai Hospital, Shanghai, China.
J Surg Res. 2015 May 1;195(1):344-50. doi: 10.1016/j.jss.2014.12.025. Epub 2014 Dec 18.
Microskin autografts with conventional wrap and compression are used extensively in the treatment of skin and tissue defects. This comparative study aimed at investigation of the clinical application of negative pressure wound therapy (NPWT) in combination with microskin autografts for repair of acute and chronic wounds.
A prospective case-control study was performed from December 1, 2010-December 31, 2013 in Changhai Hospital, Shanghai. We compared a study group of patients received microskin autografting covered by NPWT with that of a control group of patients received microskin autografting covered by a conventional gauze.
A total of 81 patients were in this study, 27 patients were allocated to the study group and 54 patients to the control group. The study group exhibited significant low infection rate and pain score during removal of inner layer at first dressing change after skin grafting compared with those of the control group (P < 0.05). The time interval between skin grafting and first postoperative change was longer in the study group than that in the control group (P < 0.01), the study group showed a significant shorter 95% wound healing time (P < 0.05), and survival rate of microskin autografts in the study group was higher than that in the control group (P < 0.05).
NPWT is beneficial for wound closure after microskin autografts, which prolongs the interval between skin transplantation and first postoperative dressing change, reduces pain during removal of inner layer dressing, increases skin graft survival rate, and shortens wound healing time. Therefore, NPWT can be recommended for repair of acute and chronic wounds with microskin autografts.
采用传统包扎和加压的微型自体皮移植广泛应用于皮肤和组织缺损的治疗。本对比研究旨在探讨负压伤口治疗（NPWT）联合微型自体皮移植修复急慢性伤口的临床应用。
2010年12月1日至2013年12月31日在上海长海医院进行一项前瞻性病例对照研究。我们将接受NPWT覆盖微型自体皮移植的患者研究组与接受传统纱布覆盖微型自体皮移植的患者对照组进行比较。
本研究共纳入81例患者，27例患者被分配至研究组，54例患者被分配至对照组。与对照组相比，研究组在植皮后首次换药时去除内层敷料期间的感染率和疼痛评分显著较低（P<0.05）。研究组植皮与术后首次换药之间的时间间隔比对照组更长（P<0.01），研究组的95%伤口愈合时间显著更短（P<0.05），且研究组微型自体皮移植的成活率高于对照组（P<0.05）。
NPWT有利于微型自体皮移植后的伤口闭合，可以延长皮肤移植与术后首次换药之间的间隔时间，减轻去除内层敷料时的疼痛，提高植皮成活率，并缩短伤口愈合时间。因此，对于使用微型自体皮移植修复急慢性伤口，推荐使用NPWT。
