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一种新型皮肤拉伸装置,用于软组织肉瘤切除后闭合大面积皮肤软组织缺损。

A novel skin-stretching device for closing large skin-soft tissue defects after soft tissue sarcoma resection.

机构信息

Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Department of Orthopedics, Linqing City people's Hospital, Linqing, 252600, Shandong, China.

出版信息

World J Surg Oncol. 2020 Sep 17;18(1):247. doi: 10.1186/s12957-020-02022-3.

DOI:10.1186/s12957-020-02022-3
PMID:32943050
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7499963/
Abstract

BACKGROUND

Closure of large skin-soft tissue defects following soft tissue sarcoma (STS) resection has been a great challenge. The objective of this study was to evaluate the effectiveness of a novel, simple, and cheap skin-stretching device (bidirectional regulation-hook skin closure system, BHS) for closing large skin-soft tissue defects resulting from the removal of STS and the complications associated with the use of the BHS.

METHODS

From January 2017 to September 2018, 25 patients with STS underwent BHS therapy after tumor resection. BHS was used for two main clinical applications: securing wound closure after high-tension suture closure and delayed wound closure. We described a detailed reconstruction procedure regarding this therapy. Wound closure and complications associated with BHS therapy were recorded. We also analyzed tumor recurrence and metastases.

RESULTS

All patients were observed for 16-36 months with an average follow-up of 25.6 months. During the follow-up period, no significant functional restriction was observed and the final scar was aesthetically acceptable. Superficial wound infection occurred in six patients, wound edge ischemia in two patients, and small skin tears in two patients. Two patients developed pulmonary metastasis, two patients had a local recurrence, and one patient died of pulmonary metastasis.

CONCLUSIONS

BHS therapy can effectively close large skin-soft tissue defects following STS resection and obtain acceptable functional results, without severe complications. However, larger studies are required to further evaluate the effectiveness, indications, and complications of BHS therapy.

摘要

背景

软组织肉瘤(STS)切除术后,大面积皮肤软组织缺损的闭合一直是一个巨大的挑战。本研究的目的是评估一种新型、简单且廉价的皮肤拉伸装置(双向调节钩皮闭合系统,BHS)用于闭合 STS 切除后引起的大面积皮肤软组织缺损的有效性,以及使用 BHS 相关的并发症。

方法

自 2017 年 1 月至 2018 年 9 月,25 例 STS 患者在肿瘤切除后接受 BHS 治疗。BHS 主要用于两种临床应用:在高张力缝合闭合后固定伤口闭合和延迟伤口闭合。我们详细描述了该治疗的重建过程。记录了伤口闭合和 BHS 治疗相关的并发症。我们还分析了肿瘤复发和转移的情况。

结果

所有患者均随访 16-36 个月,平均随访 25.6 个月。在随访期间,未观察到明显的功能受限,最终的疤痕美观可接受。6 例患者出现浅表伤口感染,2 例患者出现伤口边缘缺血,2 例患者出现小皮肤撕裂。2 例患者发生肺转移,2 例患者局部复发,1 例患者死于肺转移。

结论

BHS 治疗可有效闭合 STS 切除术后的大面积皮肤软组织缺损,并获得可接受的功能结果,且无严重并发症。然而,需要更大规模的研究来进一步评估 BHS 治疗的有效性、适应证和并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/2de07be205db/12957_2020_2022_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/6964fd98ea69/12957_2020_2022_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/9b34855ec604/12957_2020_2022_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/2de07be205db/12957_2020_2022_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/6964fd98ea69/12957_2020_2022_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/9b34855ec604/12957_2020_2022_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ac5/7499963/2de07be205db/12957_2020_2022_Fig3_HTML.jpg

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