Song Yong-Huan, Li Shi, Lin Da-Mu, Lin Xiao-Yang, Zhou Fei-Ya, Chen Yi-Heng, Chen Xing-Long, Li Zhi-Jie, Gao Wei-Yang
Department of Hand Surgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China.
Department of Hand Surgery, the Second Affiliated Hospital of Wenzhou Medical University, Wenzhou 325027, Zhejiang, China;
Zhongguo Gu Shang. 2016 Aug 25;29(8):761-763. doi: 10.3969/j.issn.1003-0034.2016.08.017.
To investigate the effect of vacuum sealing drainage (VSD) combined with artificial dermis for treatment of the ankle and foot soft tissue defects.
A total of 15 patients with skin and soft tissue defect of ankle and foot were treated from January 2011 to December 2013, including 10 males and 5 females, with an average age of 32.5 years old ranging from 3 to 55 years old, involving 8 cases by traffic accident, 2 cases by machine accident, 5 cases by crush injury;8 cases with soft tissue exposure, 2 cases with tendor exposure, 5 cases with bone exposure. VSD was used to cover the wounds and continuous negative pressure drainage after debridement, the wounds covered with artificial dermis after the second granulation tissue grew well, again VSD was used to cover the wounds and negative pressure suction was applied, after 7 to 14 days negative pressure closed drainage was removed, free skin graft was transplanted above the artificial dermis, sterile gauze was used to compression bandage.
All cases were followed up for 3 to 14 months with an average of 6.5 months. Skin graft of 15 of patients survived after transplantation, artificial dermis graft interval was 7 to 14 days with an average of 9.5 days. There was no obvious scar hyperplasia and contracture, no obvious pigmentation, appearance and functional recovery.
After the implantation of artificial dermis and traditional skin graft method need for 2 to 3 weeks, vacuum sealing drainage technique combined with artificial dermis in treatment of soft tissue defect of foot and ankle skin has advantages of simple operation, significantly shorten the time of the second phase of the skin, without flap to repair, little injury to donor skin area, wound healing quality high, clinical effect of satisfaction.
探讨封闭式负压引流（VSD）联合人工真皮治疗足踝部软组织缺损的效果。
选取2011年1月至2013年12月收治的15例足踝部皮肤软组织缺损患者，其中男10例，女5例，平均年龄32.5岁（3～55岁）。致伤原因：交通事故伤8例，机器伤2例，挤压伤5例；软组织外露8例，肌腱外露2例，骨外露5例。清创后采用VSD覆盖创面持续负压引流，待二期肉芽组织生长良好后创面覆盖人工真皮，再次采用VSD覆盖创面行负压吸引，7～14 d后去除负压封闭引流，在人工真皮上方移植游离皮片，采用无菌纱布加压包扎。
所有患者均获随访，随访时间3～14个月，平均6.5个月。15例患者皮片移植后均存活，人工真皮移植间隔时间7～14 d，平均9.5 d。术后无明显瘢痕增生及挛缩，无明显色素沉着，外形及功能恢复良好。
传统人工真皮植入后植皮方法需2～3周，封闭式负压引流技术联合人工真皮治疗足踝部皮肤软组织缺损具有操作简单、明显缩短二期植皮时间、无需皮瓣修复、供皮区损伤小、创面愈合质量高、临床效果满意等优点。
