Dong Qiqiang, Gu Guojun, Wang Lijun, Fu Keda, Xie Shuqiang, Zhang Songjian, Zhang Huafeng, Wu Zhaosen
The Third Department of Surgery, Zhengzhou Renji Hospital, Zhengzhou Henan, 450000, P.R.China.
The Third Department of Surgery, Zhengzhou Renji Hospital, Zhengzhou Henan, 450000,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Dec 15;31(12):1481-1484. doi: 10.7507/1002-1892.201707103.
To investigate the application of modified adjustable skin stretching and secure wound-closure system in repairing of skin and soft tissue defect.
Between March 2016 and April 2017, 21 cases of skin and soft tissue defects were repaired with the modified adjustable skin stretching and secure wound-closure system (the size of regulating pressure and the times of adjustment were determined according to the color, temperature, capillary response, and swelling degree of the skin edge). There were 11 males and 10 females, with an average age of 49.2 years (range, 21-67 years). Among them, 1 case was the residual wound after amputation of leg; 18 cases were the wounds after traumatic injury operation, including 4 cases in the lower leg, 3 cases in the knee joint, 7 cases in the upper limb, and 4 cases in the foot; and 2 cases were diabetic feet. The skin defect area ranged from 4.0 cm×2.5 cm to 21.0 cm×10.0 cm.
Skin defect wounds closed directly in one stage in 4 cases; 12 cases were closed after continuously stretching for 5-14 days (mean, 10 days); 5 cases were reduced to less than one-half area, and the wound healed after the second skin grafting or flap repairing. All the 21 patients were followed up 3-12 months (mean, 5.2 months). The wound was linear healing with small scar, and no invasive margin, poor blood flow, necrosis, and poor sensory function happened.
The modified adjustable skin stretching and secure wound-closure system can reduce the skin and soft tissue defects or close the wound directly, and even replace the skin graft and skin flap repairing. It was a good method for the treatment of skin and soft tissue defect.
探讨改良可调式皮肤牵张与伤口牢固闭合系统在皮肤软组织缺损修复中的应用。
2016年3月至2017年4月，采用改良可调式皮肤牵张与伤口牢固闭合系统修复21例皮肤软组织缺损患者（根据皮肤边缘的颜色、温度、毛细血管反应及肿胀程度确定调节压力大小及调节次数）。其中男11例，女10例，平均年龄49.2岁（21 - 67岁）。其中1例为小腿截肢术后残端创面；18例为外伤手术后创面，其中小腿4例，膝关节3例，上肢7例，足部4例；2例为糖尿病足。皮肤缺损面积为4.0 cm×2.5 cm至21.0 cm×10.0 cm。
4例皮肤缺损创面一期直接闭合；12例经持续牵张5 - 14天（平均10天）后闭合；5例缩小至原面积的一半以下，经二次植皮或皮瓣修复后创面愈合。21例患者均获随访3 - 12个月（平均5.2个月）。创面呈线状愈合，瘢痕小，未出现切缘浸润、血运差、坏死及感觉功能不良等情况。
改良可调式皮肤牵张与伤口牢固闭合系统可缩小皮肤软组织缺损或直接闭合创面，甚至可替代植皮和皮瓣修复，是治疗皮肤软组织缺损的一种良好方法。
