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[封闭式负压引流联合游离植皮修复创伤性小腿截肢残端皮肤缺损]

[Vacuum sealing drainage combined with free skin graft in repairing cutaneous deficiency of traumatic shank amputation stump].

作者信息

Zhao Xiao-fei, Li Chun-you, Jin Guo-qiang, Ming Xiao-feng, Wang Guo-jie

出版信息

Zhongguo Gu Shang. 2014 Dec;27(12):1036-9.

Abstract

OBJECTIVE

To observe clinical efficacy in treating cutaneous deficiency of traumatic shank amputation stump with full-thickness skin graft combined with vacuum sealing drainage.

METHODS

From September 2009 to December 2012, 15 patients with cutaneous deficiency of traumatic shank amputation stump were treated with full-thickness skin graft combined with vacuum sealing drainage. Among patients, there were 11 males and 4 females with an average age of 41.5 (ranged from 25 to 62) years old. Ten cases were caused by traffic accident and 5 cases were caused by heavy object, 9 cases on left and 6 cases on right. Six patients with smashed wound were treated with debridement and amputation, combined with vacuum aspiration in-emergency; 9 patients caused by infection and necrosis were treated with debridement and amputation, combined with vacuum aspiration, and full-thickness skin graft were performed at stage II. The skin defect area of residual limbs ranged from 40 cm x 20 cm to 25 cm x 15 cm.

RESULTS

All patients were followed up from 3 months to 1 year. Full-thickness skin graft of residual limbs were survived,and obtained satisfactory walking function with prosthetic. Residual skin increased thicken, wearproof without rupture and pain.

CONCLUSION

Full-thickness skin graft combined with vacuum sealing drainage in treating cutaneous deficiency of traumatic shank amputation stump could reserve the length of residual limbs, increase survival rate of skin graft with less scar of survival skin, get good wearability and it is conducive to prosthetic wear. It is a simple and easy treatment method.

摘要

目的

观察采用全厚皮片移植联合封闭式负压引流治疗创伤性小腿截肢残端皮肤缺损的临床疗效。

方法

选取2009年9月至2012年12月收治的15例创伤性小腿截肢残端皮肤缺损患者,采用全厚皮片移植联合封闭式负压引流治疗。其中男11例,女4例,平均年龄41.5岁(25~62岁)。交通事故致伤10例,重物砸伤5例;左侧9例,右侧6例。6例创面毁损严重者行清创截肢,急诊联合负压吸引;9例因感染坏死者行清创截肢,联合负压吸引,二期行全厚皮片移植。残肢皮肤缺损面积为40 cm×20 cm至25 cm×15 cm。

结果

所有患者随访3个月至1年。残肢全厚皮片成活,安装假肢后行走功能良好。残留皮肤增厚、耐磨,无破溃及疼痛。

结论

全厚皮片移植联合封闭式负压引流治疗创伤性小腿截肢残端皮肤缺损,可保留残肢长度,提高皮片成活率,成活皮肤瘢痕少,耐磨性好,有利于假肢穿戴,是一种简便易行的治疗方法。

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