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[自制封闭式负压引流装置在上肢深度烧伤8例腹部带蒂皮瓣术后固定与引流中的应用]

[Application of self-made vacuum sealing drainage device in postoperative fixation and drainage of abdominal pedicled flaps in 8 patients with deep burns of upper limbs].

作者信息

Yuan D L, Zhao Y H, Deng H T, Xu L L

机构信息

Department of Burns and Plastic Surgery, the Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin 214400, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2019 Aug 20;35(8):611-613. doi: 10.3760/cma.j.issn.1009-2587.2019.08.011.

Abstract

From January 2013 to December 2017, 8 patients with deep burns of upper limbs were admitted to our hospital, including 6 males and 2 females, aged 23-48 years. The wound area of full-thickness burns to burns with tendon and bone injury was 4.5 cm×2.0 cm-20.0 cm×10.5 cm. After debridement, thin abdominal flaps with subdermal vascular network in the size of 5.0 cm×2.5 cm-22.0 cm×12.0 cm were applied to cover the wounds, and the donor sites were sutured directly by relaxation. The disposable suction tubes with holes cut on side walls were used as drainage tubes. The part of drainage tubes with holes were wrapped with nano-silver antimicrobial dressings and then placed at the lowest position of pedicle and donor site of abdominal flap and the space between the injured limb and the abdominal wall. The loose nano-silver antibacterial dressing was used to fill the webs of fingers and the gap between the injured limb and the abdominal wall. The transparent film dressing was used to close the surgical area and then connected with a low negative voltage electric suction device to continuously suck at a negative pressure of -15 to -10 kPa. The self-made vacuum sealing drainage device was replaced at intervals of 4 to 5 days until pedicle breakage was performed 2 to 3 weeks after operation. The pedicled abdominal flaps of 8 patients had no torsion or avulsion, no pedicle blood supply disorder, and no infection or skin erosion in the operation area, and all the flaps survived after pedicle breakage.

摘要

2013年1月至2017年12月,我院收治8例上肢深度烧伤患者,其中男6例,女2例,年龄23 - 48岁。全层烧伤至伴有肌腱和骨骼损伤的烧伤创面面积为4.5 cm×2.0 cm - 20.0 cm×10.5 cm。清创后,应用面积为5.0 cm×2.5 cm - 22.0 cm×12.0 cm的带真皮下血管网的薄型腹部皮瓣覆盖创面,供区直接拉拢缝合。将侧壁开孔的一次性吸引管作为引流管。将开孔部分的引流管用纳米银抗菌敷料包裹,然后放置于腹部皮瓣蒂部和供区的最低位置以及伤肢与腹壁之间的间隙。用松散的纳米银抗菌敷料填充指蹼及伤肢与腹壁之间的间隙。用透明薄膜敷料封闭手术区域,然后连接低负压电动吸引装置,以-15至-10 kPa的负压持续吸引。自制的封闭式负压引流装置每4至5天更换一次,直至术后2至3周行断蒂术。8例患者的带蒂腹部皮瓣均无扭转或撕脱,无蒂部血运障碍,手术区域无感染或皮肤糜烂,断蒂后皮瓣全部成活。

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