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Z 成形术有助于慢性难愈合伤口的愈合。

The Z-plasty contributes to the coalescence of a chronic non-healing wound.

机构信息

Department of Plastic Surgery, Peking University Third Hospital, Beijing, China.

出版信息

Int Wound J. 2021 Dec;18(6):796-804. doi: 10.1111/iwj.13583. Epub 2021 Mar 17.

Abstract

This study aimed to explore the treatment effect of Z-plasty on a non-healing wound. A total of 72 patients diagnosed with a chronic non-healing wound in Peking University Third Hospital from November 2009 to August 2019 were retrospectively analysed. Among them, 27 patients were treated with Z-plasty, and 45 patients were treated with the general method. Detailed patient information was retrieved from medical records, including age, gender, body mass index (BMI), alcohol, smoking, and comorbidities (diabetes mellitus, hypertension, heart disease). Surgical parameters included operation time and intraoperative blood loss. Wound swelling, epidermal blisters, wound edge colour, and skin temperature at 1 day after surgery were assessed to evaluate the blood supply of the wound. Surgical complications included infection, haematoma, dehiscence, and non-healing within 2 weeks postoperatively. Student t test (for continuous data) and Chi-square test (for categorical data) were conducted to determine the statistical difference. We found no significant differences in age, gender, BMI, alcohol, smoking, and comorbidities between the two groups. Z-plasty did not show any advantages in the surgical time, invasive blood loss, hospital days, and hospitalisation expenses. The incidence of abnormal wound edge colour with Z-plasty was significantly lower than that with the general treatment (P < .05), and the Z-plasty enables better healing of the patient's wound (P < .05). Z-plasty promoted better recovery of chronic non-healing wounds than direct suturing.

摘要

本研究旨在探讨 Z 成形术治疗非愈合性伤口的疗效。回顾性分析 2009 年 11 月至 2019 年 8 月在北京大学第三医院就诊的 72 例慢性非愈合性伤口患者。其中,27 例行 Z 成形术治疗,45 例行常规方法治疗。从病历中检索详细的患者信息,包括年龄、性别、体重指数(BMI)、饮酒、吸烟和合并症(糖尿病、高血压、心脏病)。手术参数包括手术时间和术中失血量。评估术后 1 天的伤口肿胀、表皮水疱、伤口边缘颜色和皮肤温度,以评估伤口的血液供应。手术并发症包括术后 2 周内感染、血肿、裂开和不愈合。采用 Student t 检验(连续数据)和卡方检验(分类数据)确定统计学差异。我们发现两组患者在年龄、性别、BMI、饮酒、吸烟和合并症方面无显著差异。Z 成形术在手术时间、侵袭性失血量、住院天数和住院费用方面没有优势。Z 成形术组异常伤口边缘颜色的发生率明显低于常规治疗组(P<.05),Z 成形术组患者伤口愈合更好(P<.05)。Z 成形术促进慢性不愈合伤口的恢复优于直接缝合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7157/8613384/4e96333c8cb0/IWJ-18-796-g002.jpg

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