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利用负压伤口治疗重建一位八旬老人的严重胫骨前脱套伤,随后联合使用带孔型人工真皮且无需植皮。

Reconstruction of an Octogenarian Major Pretibial Degloving Injury Utilizing Negative Pressure Wound Therapy and Subsequently Combining Fenestrated-Type Artificial Dermis Without Skin Grafting.

作者信息

Hung Wei-Chung, Chicco Maria, Huang Tony Chieh-Ting, Cheng Hsu-Tang

机构信息

Department of Surgery, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan, Taiwan.

Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Slough, UK.

出版信息

Int J Low Extrem Wounds. 2023 Mar;22(1):210-212. doi: 10.1177/1534734620983251. Epub 2021 Mar 9.

Abstract

Major pretibial degloving injuries are complex wounds, which can be challenging to treat. Despite recent advances in reconstructive options, most of these injuries still require a prolonged healing period and may result in amputation. Few reports have been published on the management of these complex traumatic injuries. In this article, we present a case of an octogenarian, frail patient with a major pretibial degloving injury. Treatment included serial surgical debridements in combination with negative pressure wound therapy aimed at salvaging the avulsed tissue. Subsequently, a fenestrated-type artificial dermis and negative pressure wound therapy were used as combined therapy so as to obtain adequate soft tissue coverage. The patient made an unremarkable recovery and was discharged on day 22 after injury. The wound healed by secondary intention without need for skin grafting.

摘要

严重的胫骨前皮肤脱套伤是复杂的伤口,治疗起来可能具有挑战性。尽管近年来重建治疗方法有所进展,但大多数此类损伤仍需要较长的愈合期,且可能导致截肢。关于这些复杂创伤性损伤的治疗报道较少。在本文中,我们介绍了一例患有严重胫骨前皮肤脱套伤的八旬体弱患者。治疗包括系列手术清创,并结合负压伤口治疗以挽救撕脱组织。随后,使用开窗型人工真皮和负压伤口治疗作为联合治疗,以获得足够的软组织覆盖。患者恢复良好,受伤后第22天出院。伤口通过二期愈合,无需植皮。

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