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自制慢性伤口闭合装置在下肢瘢痕创面修复中的应用

[Application of self-made chronic wound closure device in the repair of scarred lower extremity wounds].

作者信息

Pu Shaoquan, Lü Qian, Zhao Zeyu, Hu Dan, Chen Xiang, Chen Hanfen, Zhu Yueliang, Xu Yongqing

机构信息

Department of orthopedics, the Joint Service Support Force 920 th Hospital of Chinese PLA, Kunming Yunnan, 650032, P.R.China.

Department of orthopedics, the Joint Service Support Force 920 th Hospital of Chinese PLA, Kunming Yunnan, 650032,

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Feb 15;33(2):219-222. doi: 10.7507/1002-1892.201803045.

Abstract

OBJECTIVE

To investigate the effectiveness of self-made limb chronic wound closure device in the treatment of scarred lower limbs and complex skin and soft tissue defects.

METHODS

Between January 2014 and January 2017, 29 patients with complex fractures of the lower extremities and skin and soft tissue defects were treated. There were 19 males and 10 females with an average age of 31.1 years (range, 21-66 years). The causes of injury included 14 cases of traffic accidents, 5 cases of falling from height, 4 cases of heavy object crushing injury, 4 cases of mechanical crushing injury, and 2 cases of exposed steel plate after fracture. There were 26 cases of calf fracture and skin defect, 3 cases of metatarsal bone fracture and skin defect of the foot. The skin defect ranged from 5 cm×3 cm to 18 cm×8 cm. The time from injury to admission was 5-31 days, with an average of 14.3 days. All patients underwent a thorough debridement, open wound drainage, self-made chronic wound closure device combined with Ilizarov stretching technique for a slow skin and soft tissue traction. After the wound was cleaned up and the granulation tissue was freshened, the skins on both sides were closed, and then proceed to the second stage operation of skin grafting or direct suture closure based on the size of the wound.

RESULTS

All patients were followed up 8-20 months, with an average of 13 months. Twenty-nine patients were treated with self-made chronic wound closure device combined with Ilizarov technique for 1-2 times with an average of 1.3 times, then the wound infection was controlled and the granulation tissue grew well. In the course of treatment, the pain was not obvious and the patients had good compliance. All patients' wounds healed clinically without skin traction complications and formed linear or flaky scars.

CONCLUSION

The self-made chronic wound closure device is effective in repairing complex scarred wounds of lower extremities, and it is easy to operate.

摘要

目的

探讨自制肢体慢性伤口闭合装置治疗下肢瘢痕及复杂皮肤软组织缺损的疗效。

方法

2014年1月至2017年1月,收治29例下肢复杂骨折合并皮肤软组织缺损患者。其中男性19例,女性10例,平均年龄31.1岁(范围21 - 66岁)。致伤原因包括交通事故14例、高处坠落5例、重物砸伤4例、机械绞伤4例、骨折后钢板外露2例。小腿骨折伴皮肤缺损26例,足部跖骨骨折伴皮肤缺损3例。皮肤缺损范围为5 cm×3 cm至18 cm×8 cm。受伤至入院时间为5 - 31天,平均14.3天。所有患者均行彻底清创、开放伤口引流,采用自制慢性伤口闭合装置联合Ilizarov牵伸技术进行缓慢的皮肤软组织牵引。伤口清理、肉芽组织 freshened 后,闭合两侧皮肤,然后根据伤口大小进行二期植皮或直接缝合闭合手术。

结果

所有患者随访8 - 20个月,平均13个月。29例患者采用自制慢性伤口闭合装置联合Ilizarov技术治疗1 - 2次,平均1.3次,伤口感染得到控制,肉芽组织生长良好。治疗过程中疼痛不明显,患者依从性好。所有患者伤口均临床愈合,无皮肤牵引并发症,形成线状或片状瘢痕。

结论

自制慢性伤口闭合装置修复下肢复杂瘢痕伤口疗效确切,且操作简便。

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