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负压伤口疗法(NPWT)在后颅窝压疮的皮瓣和植皮混合重建术后的应用。

Negative Pressure Wound Therapy (NPWT) after Hybrid Reconstruction of Occipital Pressure Sore Using Local Flap and Skin Graft.

机构信息

Department of Plastic and Reconstructive Surgery, SMG-SNU Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea.

出版信息

Medicina (Kaunas). 2023 Jul 21;59(7):1342. doi: 10.3390/medicina59071342.

Abstract

Pressure sores are a common medical burden among patients, particularly those who are bedridden or frail. Surgical management of occipital pressure sores poses unique challenges due to limited elasticity and the spherical shape of the scalp. This study aims to evaluate the efficacy and safety of a novel reconstruction method utilizing a local transpositional flap and split-thickness skin graft with negative pressure wound therapy (NPWT) for occipital pressure sore treatment. A retrospective analysis was performed on patients with occipital pressure sores who underwent hybrid reconstructions using a local flap and split-thickness skin graft in conjunction with NPWT. Surgical outcomes, including flap survival rate, graft take percentage, and complications, were assessed. A comparative analysis was performed between the NPWT group and the conventional dressing group. The NPWT group ( = 24) demonstrated a significantly higher mean graft take percentage at postoperative day 14 compared with the conventional dressing group (n = 22) (98.2% vs. 81.2%, < 0.05). No significant difference in flap survival rate was observed between the two groups. As the aging population continues to grow, occipital pressure sores have gained significant attention as a crucial medical condition. The innovative surgical method incorporating NPWT offers an efficient and safe treatment option for patients with occipital pressure sores, potentially establishing itself as the future gold standard for managing this condition.

摘要

压力性溃疡是患者中常见的医疗负担,特别是那些卧床不起或身体虚弱的患者。由于头皮弹性有限和球形形状,枕部压力性溃疡的手术管理带来了独特的挑战。本研究旨在评估一种利用局部移位皮瓣和负压伤口治疗(NPWT)的游离皮片治疗枕部压力性溃疡的新型重建方法的疗效和安全性。

对接受局部皮瓣和游离皮片联合 NPWT 混合重建的枕部压力性溃疡患者进行回顾性分析。评估手术结果,包括皮瓣存活率、植皮成活率和并发症。对 NPWT 组和常规敷料组进行了比较分析。

NPWT 组(n=24)术后第 14 天的平均植皮成活率明显高于常规敷料组(n=22)(98.2% vs. 81.2%,<0.05)。两组皮瓣存活率无显著差异。

随着人口老龄化的不断增长,枕部压力性溃疡作为一种重要的医疗状况引起了广泛关注。结合 NPWT 的创新手术方法为枕部压力性溃疡患者提供了一种高效、安全的治疗选择,有可能成为治疗这种疾病的未来金标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fcd0/10386472/fb266aef4178/medicina-59-01342-g001.jpg

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