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负压伤口治疗增强猫的全层游离皮肤移植:10块移植皮片移植到6只猫的结果

Negative pressure wound therapy augmented full-thickness free skin grafting in the cat: outcome in 10 grafts transferred to six cats.

作者信息

Nolff Mirja C, Meyer-Lindenberg Andrea

机构信息

Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Munich, Germany

Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Munich, Germany.

出版信息

J Feline Med Surg. 2015 Dec;17(12):1041-8. doi: 10.1177/1098612X15569893. Epub 2015 Feb 5.

Abstract

OBJECTIVES

The aim of this clinical evaluation was to describe the technique and outcomes of negative pressure wound therapy (NPWT) augmented skin grafting in cats.

METHODS

Cats with soft tissue and skin defects (n = 6) underwent open wound management. Wounds were initially covered using a NPWT system that was changed to polyurethane foam dressing once infection was controlled and granulation started. Final closure was achieved after establishment of a healthy, fully granulated wound bed by grafting of free full-thickness skin from the lateral abdominal wall. The freshly grafted skin was then treated with an NPWT dressing at a pressure of -125 mmHg for 3 days, with dressing changes performed daily. Percentage graft take, complications, wound bioburden and cosmetic outcome were recorded.

RESULTS

The mean duration of open wound management was 21.4 days (range 3.0-45.0 days), with a mean duration of NPWT of 8.0 days (range 3.0-14.0 days). Five cats received a single graft, while one cat had five grafts transferred to the right hindlimb. In 7/10 grafts, graft take was 100%, in two grafts take was 95% and in one graft take was 80% (mean take rate 97%). Therapy was well tolerated in all patients. The grafted site displayed normal hair regrowth in four cats, sparse hair regrowth in one and no hair growth at all in one patient. Skin sensation was normal in all grafted patients.

CONCLUSIONS AND RELEVANCE

Skin graft augmentation using NPWT in cats is a feasible option that allows graft fixation, even in anatomically demanding areas. Graft take rate reported here is slightly higher than documented in previous reports.

摘要

目的

本临床评估的目的是描述负压伤口治疗(NPWT)辅助猫皮肤移植的技术和结果。

方法

6只患有软组织和皮肤缺损的猫接受了开放性伤口处理。伤口最初使用NPWT系统覆盖,一旦感染得到控制且开始形成肉芽组织,就更换为聚氨酯泡沫敷料。通过移植来自侧腹壁的游离全层皮肤,在建立健康、完全长满肉芽的伤口床后实现最终闭合。然后用NPWT敷料在-125 mmHg的压力下对新移植的皮肤进行3天治疗,每天更换敷料。记录移植成活率、并发症、伤口生物负荷和美容效果。

结果

开放性伤口处理的平均持续时间为21.4天(范围3.0 - 45.0天),NPWT的平均持续时间为8.0天(范围3.0 - 14.0天)。5只猫接受了单次移植,而1只猫有5次移植到右后肢。在10次移植中,7次移植成活率为100%,2次为95%,1次为80%(平均成活率97%)。所有患者对治疗耐受性良好。4只猫的移植部位毛发生长正常,1只稀疏,1只完全没有毛发生长。所有移植患者的皮肤感觉均正常。

结论及意义

在猫中使用NPWT进行皮肤移植增强是一种可行的选择,即使在解剖结构复杂的区域也能实现移植固定。此处报告的移植成活率略高于以往报告中的记录。

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