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评估高压氧疗法对改善一期真皮替代物和皮肤移植的效果:一项对比研究。

Evaluating Hyperbaric Oxygen Therapy to Improve Single-Stage Dermal Substitute and Skin Grafting: A Comparative Study.

作者信息

Korambayil Pradeoth Mukundan, Sanghvi Hemang Arvind, Dilliraj Vinoth Kumar, Ambookan Prashanth Varkey

机构信息

Department of Plastic Surgery and Burns, Jubilee Mission Medical College and Research Institute, Thrissur, Kerala, India.

Department of Plastic Surgery, Vijaya Hospital, Chennai, Tamil Nadu, India.

出版信息

Indian J Plast Surg. 2024 Jul 18;57(Suppl 1):S92-S99. doi: 10.1055/s-0044-1788592. eCollection 2024 Dec.

Abstract

Dermal substitutes offer a valuable tool in soft-tissue reconstruction, reducing the need for donor site tissue and its associated complications. However, conventional approaches often require multiple surgeries. This study aimed to compare the effectiveness of a single-stage procedure combining dermal substitute and skin grafting with hyperbaric oxygen (HBO) therapy to the standard multistage protocol.  A comparative study was conducted from January 2022 to December 2023. The medical records of 24 patients who underwent soft-tissue reconstruction were reviewed. Patients were categorized into two groups based on whether they received HBO therapy (HBO group) or followed the standard multistage protocol (control group). Outcomes were compared between the groups.  The study included 18 males and 6 females with an average age of 43 years (range: 5-91 years). Underlying medical conditions included diabetes mellitus (  = 11) and peripheral vascular disease (  = 2). Wounds were due to various causes, including necrotizing fasciitis (  = 2), trauma (  = 10), diabetic ulcers (  = 6), postburn hypertrophic scars/contractures (  = 3), chronic ulcers (  = 1), and sternal wound dehiscence (  = 1). All the patients achieved successful wound closure with dermal substitute application, eliminating the need for additional surgery. Notably, the group receiving HBO therapy experienced a shorter overall hospital stay compared with the standard multistage group.  This study demonstrates the effectiveness of dermal substitutes in soft-tissue reconstruction. Furthermore, the addition of HBO therapy in a single-stage procedure appears beneficial for successful outcomes, potentially reducing hospital stay compared with the traditional multistage approach.

摘要

皮肤替代物为软组织重建提供了一种有价值的工具,减少了对供区组织及其相关并发症的需求。然而,传统方法通常需要多次手术。本研究旨在比较将皮肤替代物与皮肤移植相结合的单阶段手术联合高压氧(HBO)治疗与标准多阶段方案的有效性。

2022年1月至2023年12月进行了一项比较研究。回顾了24例接受软组织重建患者的病历。根据患者是否接受HBO治疗(HBO组)或遵循标准多阶段方案(对照组)将其分为两组。比较两组之间的结果。

该研究包括18名男性和6名女性,平均年龄43岁(范围:5 - 91岁)。基础疾病包括糖尿病(n = 11)和外周血管疾病(n = 2)。伤口由多种原因引起,包括坏死性筋膜炎(n = 2)、创伤(n = 10)、糖尿病溃疡(n = 6)、烧伤后增生性瘢痕/挛缩(n = 3)、慢性溃疡(n = 1)和胸骨伤口裂开(n = 1)。所有患者通过应用皮肤替代物均成功闭合伤口,无需额外手术。值得注意的是,与标准多阶段组相比,接受HBO治疗的组总体住院时间更短。

本研究证明了皮肤替代物在软组织重建中的有效性。此外,在单阶段手术中添加HBO治疗似乎有利于取得成功的结果,与传统多阶段方法相比可能缩短住院时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c6f0/11684969/929bbc17f5b9/10-1055-s-0044-1788592-i2432753-1.jpg

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