Hu Wei, Shao Yin-Chu, Li Hao, Shan Ji-Chun, Yang Hong, Shuang Feng
Department of Orthopaedics, the 908th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China.
Department of Orthopaedics, the 908th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China;
Zhongguo Gu Shang. 2019 Nov 25;32(11):1021-1025. doi: 10.3969/j.issn.1003-0034.2019.11.009.
To compare clinical effects of tension-relief system(TRS) and self-made skin-stretching devices in treating skin and soft tissue defects caused by trauma.
Totally 41 patients with skin and soft tissue defects caused by trauma treated by skin-stretching devices were retrospectively analyzed from June 2015 to October 2016, including 28 males and 13 females, aged from 22 to 64 years old with an average of(43.2±10.4) years old. The patients were divided into two groups according to therapeutic methods, 18 patients were treated by TRS, including 11 males and 7 females, aged from 22 to 61 years old with an average of (41.7±9.5) years old; 5 patients injured on the upper limb, 11 patients on lower limb and 2 patients on the back; the area of defect ranged from 42 to 160 cm² with an average of(78.6±17.4) cm². Twenty-three patients were treated by self-made skin stretching device, included 17 males and 6 females, aged from 25 to 64 years old with an average of (44.4±12.7) years old; 6 patients injured on the upper limb, 13 patients on lower limb and 4 patients on the back; the area of defect ranged from 54 to 175 cm² with an average of(75.2±14.3) cm². Primary closure at stage I, blood loss, operation time, healing time of wound, complications between two groups were compared, VAS score was used to evaluate pain relief, vancouver scar scale(VSS) was used to assess recover of postoperative scars.
Forty-one patients were followed up ranged from 3 to 12 months with an average of(16.2±3.7) months. There were no significant difference between two groups in blood loss and operation time(>0.05). In TRS group, 16 patients' injury were closured directly, wound healing time of 16 patients were over 3 about weeks, VAS score was 3.9±1.1, VSS score was 3.5±1.2, and 1 patient occurred complication; In self-made skin stretch group, 12 patients' injury were closured directly, wound healing time of 9 patients were over 3 about weeks, VAS score was 4.8±1.4, VSS score was 5.3±1.6, and 9 patients occurred complication; there were no statistical differences between two groups in these items.
Compared with self-made skin stretch, TRS has advantages of good effect of wound, minimal trauma, short healing time, less pain, good outlook, and less complication.
比较张力释放系统（TRS）与自制皮肤拉伸装置治疗创伤所致皮肤软组织缺损的临床效果。
回顾性分析2015年6月至2016年10月采用皮肤拉伸装置治疗的41例创伤所致皮肤软组织缺损患者，其中男28例，女13例，年龄22～64岁，平均（43.2±10.4）岁。根据治疗方法将患者分为两组，18例采用TRS治疗，其中男11例，女7例，年龄22～61岁，平均（41.7±9.5）岁；上肢受伤5例，下肢11例，背部2例；缺损面积42～160 cm²，平均（78.6±17.4）cm²。23例采用自制皮肤拉伸装置治疗，其中男17例，女6例，年龄25～64岁，平均（44.4±12.7）岁；上肢受伤6例，下肢13例，背部4例；缺损面积54～175 cm²，平均（75.2±14.3）cm²。比较两组一期缝合情况、出血量、手术时间、伤口愈合时间、并发症，采用视觉模拟评分法（VAS）评估疼痛缓解情况，采用温哥华瘢痕量表（VSS）评估术后瘢痕恢复情况。
41例患者随访3～12个月，平均（16.2±3.7）个月。两组出血量和手术时间比较差异无统计学意义（>0.05）。TRS组16例患者伤口直接缝合，16例患者伤口愈合时间超过3周左右，VAS评分为3.9±1.1，VSS评分为3.5±1.2，1例发生并发症；自制皮肤拉伸组12例患者伤口直接缝合，9例患者伤口愈合时间超过3周左右，VAS评分为4.8±1.4，VSS评分为5.3±1.6，9例发生并发症；两组这些指标比较差异无统计学意义。
与自制皮肤拉伸相比，TRS具有伤口效果好、创伤小、愈合时间短、疼痛轻、外观好及并发症少等优点。
