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负压伤口治疗与传统机械固定在皮肤移植中的疗效及并发症比较:一项回顾性分析

Comparison of Efficacy and Complications Between Negative Pressure Wound Therapy and Conventional Mechanical Fixation in Skin Grafts: A Retrospective Analysis.

作者信息

Shen Xiao, Zhan Tianfu, Wei Dayong, Zhang Hengshu

机构信息

Department of Plastic and Burn Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.

出版信息

Wounds. 2019 Aug;31(8):213-218. Epub 2019 Jun 30.

Abstract

INTRODUCTION

Graft fixation is critical for the successful survival of a skin graft. Conventional mechanical fixation may induce inappropriate pressure and increase wound complications. Negative pressure wound therapy (NPWT) could be utilized to secure a skin graft and improve drainage. Limited quantitative data exist on the efficacy of NPWT for skin grafting.

OBJECTIVE

This retrospective study compares the efficacy and complications between NPWT and conventional mechanical fixation in skin grafts.

MATERIALS AND METHODS

Patients who underwent skin graft surgery from January 2015 to December 2016 at a large university hospital in southwest China were retrospectively analyzed. Characteristics, including wound pattern, skin graft type, surgical procedure, survival rate, and postoperative complication, were statistically analyzed by Pearson chi-square or Fisher's exact test.

RESULTS

A total of 186 patients were included in the study; 72 received NPWT and 114 received conventional mechanical dressing fixation after skin grafting. Overall survival rate of full-thickness skin grafts was significantly higher in the NPWT group than the dressing group (P ⟨ .01). The NPWT group showed a higher survival rate than the dressing group for each anatomic site, but only patients who had skin grafts of the hand exhibited statistically significant results.

CONCLUSIONS

This study reports a quantitative analysis of the efficacy of NPWT on skin graft fixation with NPWT providing consistent pressure and better drainage than conventional mechanical fixation. In addition, the use of NPWT also could increase graft take on the hand region.

摘要

引言

植皮固定对于皮肤移植的成功存活至关重要。传统的机械固定可能会产生不适当的压力并增加伤口并发症。负压伤口治疗(NPWT)可用于固定皮肤移植并改善引流。关于NPWT用于皮肤移植疗效的定量数据有限。

目的

本回顾性研究比较了NPWT与传统机械固定在皮肤移植中的疗效和并发症。

材料与方法

回顾性分析2015年1月至2016年12月在中国西南部一家大型大学医院接受皮肤移植手术的患者。通过Pearson卡方检验或Fisher精确检验对伤口类型、皮肤移植类型、手术过程、存活率和术后并发症等特征进行统计学分析。

结果

本研究共纳入186例患者;72例接受NPWT,114例在皮肤移植后接受传统机械敷料固定。NPWT组全厚皮肤移植的总体存活率显著高于敷料组(P<0.01)。NPWT组在每个解剖部位的存活率均高于敷料组,但只有手部皮肤移植的患者结果具有统计学意义。

结论

本研究报告了对NPWT在皮肤移植固定方面疗效的定量分析,NPWT比传统机械固定提供更均匀的压力和更好的引流。此外,使用NPWT还可提高手部区域的移植成功率。

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