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三步序贯法治疗四肢皮肤软组织缺损合并骨或肌腱外露创面
Hits: 1942   Download times: 1038   Received:May 03, 2018    
作者Author单位UnitE-Mail
杜伟斌 DU Wei-bin 浙江中医药大学附属江南医院 萧山中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China  
王利祥 WANG Li-xiang 浙江中医药大学附属江南医院 萧山中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China 123456789q002@sina.com 
吴国明 WU Guo-ming 浙江中医药大学附属江南医院 萧山中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China  
许良 XU Liang 浙江中医药大学附属江南医院 萧山中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China  
申丰 SHEN Feng 浙江中医药大学附属江南医院 萧山中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China  
曾林如 ZENG Lin-ru 浙江中医药大学附属江南医院 萧山中医院骨科, 浙江 杭州 311201 Department of Orthopaedics, Jiangnan Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 311201, Zhejiang, China  
期刊信息:《中国骨伤》2019年32卷,第8期,第742-745页
DOI:10.3969/j.issn.1003-0034.2019.08.013
基金项目:杭州市科技计划引导项目(编号:20171226Y93);杭州市萧山区重大科技攻关项目(编号:2017208)


目的:探讨采用改良VSD技术、皮耐克覆盖、自体皮移植三步序贯法治疗拒绝皮瓣修复的四肢皮肤软组织缺损合并骨或肌腱外露创面的临床疗效。

方法:2013年1月至2015年6月,采用三步序贯法治疗18例四肢创伤后皮肤软组织缺损合并骨或肌腱外露创面患者,其中男13例,女5例;年龄23~72岁,平均34.6岁;受伤至手术时间1.5~5.0 h,平均2.5 h。皮肤软组织缺损面积4.2 cm×3.1 cm~7.4 cm×5.2 cm。评估创面恢复情况及取皮创口恢复情况综合评价治疗效果。

结果:术后18例患者获得随访,时间5~16个月,平均7.6个月。所有创面深部骨肌腱组织被有效覆盖,人工真皮成活,愈合创面质地韧、外形可;创面移植皮片成活,未见明显瘢痕组织生成,外观平整,皮肤颜色略深于正常皮肤,整体效果满意。

结论:采用三步序贯法治疗拒绝皮瓣修复的四肢皮肤软组织缺损合并骨或肌腱外露创面疗效良好,具有操作简单、手术风险及创伤小等优点。
[关键词]:软组织损伤  四肢  引流术  皮肤移植
 
Three-step sequential method for limb skin and soft tissue defect combined with bone or tendon exposed wound
Abstract:

Objective:To explore clinical effect of VSD technology,coverage of artificial dermis and autograft for the treatment of limb skin soft tissue defect combined with bone or tendon exposed wound.

Methods:Eighteen patients suffered from limb skin soft tissue defect combined with bone or tendon exposed wound treated by three-step sequential method from January 2013 to June 2015. Among them,including 13 males and 5 females aged from 23 to 72 years old with an average of 34.6 years old; the time from injury to operation ranged from 1.5 to 5.0 hours with an average of 2.5 h. The area of skin and soft tissue injury ranged from 4.2 cm×3.1 cm to 7.4 cm×5.2 cm. Wound recovery and taken skin wound recovery were observed to evaluate clinical results.

Results:All patients were followed up from 5 to 16 months,with an average of 7.6 months. Deep bone tendon tissue of wounds were effectively recovered,artificial dermis survived,and quality of healed wound was tough and shape was good. Wound transplant flap was survived,no obvious scar tissue formation,appearance was flat,skin color was a little deeper than normal skin,the overall effect was satisfactory.

Conclusion:Three-step sequential method has good curative effect for patients suffered from limb skin soft tissue defect with bone or tendon exposed wound and refused to repair the flap,and has advantage of simple operation,operation risk,less invasive.
KEYWORDS:Soften tissue injury  Extremities  Drainage  Skin transplantation
 
引用本文,请按以下格式著录参考文献:
中文格式:杜伟斌,王利祥,吴国明,许良,申丰,曾林如.三步序贯法治疗四肢皮肤软组织缺损合并骨或肌腱外露创面[J].中国骨伤,2019,32(8):742~745
英文格式:DU Wei-bin,WANG Li-xiang,WU Guo-ming,XU Liang,SHEN Feng,ZENG Lin-ru.Three-step sequential method for limb skin and soft tissue defect combined with bone or tendon exposed wound[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(8):742~745
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