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负压伤口治疗对促进烧伤小腿残端皮肤移植成活的有效性：一例报告。

The effectiveness of negative pressure wound therapy in enhancing skin graft uptake on a burned lower leg stump: A case report.

作者信息

Brambullo Tito, Zanettin Chiara, Bassetto Franco, Vindigni Vincenzo

机构信息

Department of Neurosciences, Clinic of Plastic Surgery, University of Padua, Padua, Italy.

出版信息

J Orthop Case Rep. 2024 Oct;14(10):45-49. doi: 10.13107/jocr.2024.v14.i10.4806.

DOI:10.13107/jocr.2024.v14.i10.4806
PMID:39381295
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11458216/
Abstract

INTRODUCTION

Negative pressure wound therapy (NPWT) is a beneficial tool for enhancing the local conditions of complex wounds. Clinical evidence supports its application in the management of burn injuries; however, limited data are available concerning the effectiveness of NPWT on dermal substitutes and skin grafts.

CASE REPORT

A 29-year-old female patient was referred to our clinic after sustaining severe burns in a road accident. The patient's right lower limb was affected, necessitating an amputation below the knee. To preserve an adequate stump length, multiple procedures were performed, including the application of NPWT to optimize the uptake of the graft into the wound bed. The rehabilitation program for the amputated leg was aided by maintaining a suitable stump length, which can be challenging to achieve when burn damage is present.

CONCLUSION

The use of skin substitutes and grafts can benefit from the application of mild negative pressure, which can improve adherence to the wound bed. The clinical case presented highlights the benefits of NPWT in managing complex lower-limb trauma, thereby expanding the scope of this technique.

摘要

引言

负压伤口治疗（NPWT）是改善复杂伤口局部状况的一种有益手段。临床证据支持其在烧伤治疗中的应用；然而，关于NPWT对真皮替代物和皮肤移植效果的数据有限。

病例报告

一名29岁女性患者在道路交通事故中遭受严重烧伤后被转诊至我院。患者右下肢受影响，需要在膝关节以下截肢。为保留足够的残端长度，进行了多次手术，包括应用NPWT以优化移植物在伤口床的植入。通过维持合适的残端长度辅助截肢腿的康复计划，当存在烧伤损伤时，实现这一点可能具有挑战性。

结论

应用轻度负压可使皮肤替代物和移植物受益，这可改善其与伤口床的黏附。所呈现的临床病例突出了NPWT在处理复杂下肢创伤方面的益处，从而扩大了该技术的应用范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/a1ff15392813/JOCR-14-45-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/57b0101413fc/JOCR-14-45-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/916e4f797c48/JOCR-14-45-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/cdd40bca5f0e/JOCR-14-45-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/6911bfbb9a20/JOCR-14-45-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/ed39b423972f/JOCR-14-45-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/b9de46f65cee/JOCR-14-45-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/a1ff15392813/JOCR-14-45-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/57b0101413fc/JOCR-14-45-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/916e4f797c48/JOCR-14-45-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/cdd40bca5f0e/JOCR-14-45-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/6911bfbb9a20/JOCR-14-45-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/ed39b423972f/JOCR-14-45-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/b9de46f65cee/JOCR-14-45-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9648/11458216/a1ff15392813/JOCR-14-45-g007.jpg

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NPWTi allows safe delayed free flap repair of Gustilo IIIb injuries: A prospective case series.负压伤口治疗技术允许对Gustilo IIIb型损伤进行安全的延迟游离皮瓣修复：一项前瞻性病例系列研究。
Regen Ther. 2021 Apr 23;18:82-87. doi: 10.1016/j.reth.2021.04.001. eCollection 2021 Dec.
2
Negative Pressure Wound Therapy for Burns.烧伤的负压伤口治疗
Clin Plast Surg. 2017 Jul;44(3):671-677. doi: 10.1016/j.cps.2017.02.023. Epub 2017 Apr 7.
3
A prospective randomized controlled trial comparing negative pressure dressing and conventional dressing methods on split-thickness skin grafts in burned patients.
一项比较负压敷料和常规敷料方法对烧伤患者进行刃厚皮片移植的前瞻性随机对照试验。
Burns. 2011 Sep;37(6):925-9. doi: 10.1016/j.burns.2011.05.013. Epub 2011 Jul 1.
4
Effectiveness of negative pressure closure in the integration of split thickness skin grafts: a randomized, double-masked, controlled trial.负压封闭在自体中厚皮片移植融合中的有效性：一项随机、双盲、对照试验。
Ann Surg. 2006 Nov;244(5):700-5. doi: 10.1097/01.sla.0000217745.56657.e5.
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Acceleration of Integra incorporation in complex tissue defects with subatmospheric pressure.负压加速Integra在复杂组织缺损中的整合
Plast Reconstr Surg. 2004 Apr 15;113(5):1339-46. doi: 10.1097/01.prs.0000112746.67050.68.
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Development of new reconstructive techniques: use of Integra in combination with fibrin glue and negative-pressure therapy for reconstruction of acute and chronic wounds.新型重建技术的发展：使用Integra联合纤维蛋白胶及负压疗法重建急慢性伤口
Plast Reconstr Surg. 2004 Feb;113(2):525-30. doi: 10.1097/01.PRS.0000100813.39746.5A.
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The vacuum assisted closure device: a method of securing skin grafts and improving graft survival.负压封闭引流装置：一种固定皮肤移植片并提高移植片存活率的方法。
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