中国修复重建外科杂志

中国修复重建外科杂志

延时皮肤牵拉器在皮肤软组织缺损治疗中的应用

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目的总结延时皮肤牵拉器治疗皮肤软组织缺损的临床效果。方法2014 年 12 月—2016 年 12 月,采用延时皮肤牵拉器治疗皮肤软组织缺损 10 例。男 6 例,女 4 例;年龄 42~64 岁,平均 53 岁。急性创伤致皮肤软组织缺损 6 例,骨筋膜室综合征切开后切口无法闭合 3 例,巨大痈切开引流后皮肤软组织缺损 1 例。缺损部位:大腿 4 例,小腿 3 例,上臂 2 例,背部 1 例。缺损范围为 10 cm×4 cm~22 cm×12 cm。创缘行 Pinch 试验,确认创面均无法直接闭合。结果牵拉过程中,3 例出现张力性水疱;无创缘血运不畅、皮肤坏死等并发症发生。10 例患者创面经过 7~18 d 持续牵拉后明显缩小,均直接拉拢缝合;无植皮或游离皮瓣手术者。术后创口愈合良好。10 例患者均获随访,随访时间 5~8 个月,平均 6.5 个月。创缘周围均无坏死,瘢痕呈线性,感觉及功能不受影响。结论采用延时皮肤牵拉器治疗皮肤软组织缺损操作简便、手术风险低、并发症少,可获得较好疗效。

ObjectiveTo summarize the effectiveness of delayed skin-stretching device in treatment of skin and soft tissue defects.MethodsBetween December 2014 and December 2016, 10 cases of skin and soft tissue defects were treated with delayed skin-stretching device. There were 6 males and 4 females with an average age of 53 years (range, 42-64 years). The skin and soft tissue defects were caused by acute trauma in 6 cases. The incision could not be closed directly after making incisions because of osseous fascia syndrome in 3 cases. The skin soft tissue defect caused after huge carbuncle incision and drainage in 1 case. The defect located at thigh in 4 cases, lower leg in 3 cases, upper arm in 2 cases, back in 1 case. The defect area ranged from 10 cm×4 cm to 22 cm×12 cm. Pinch test was performed on the wound margin, which confirmed that the wound could not be closed directly.ResultsTension blisters were found in 3 cases during traction, and no complications such as impaired blood circulation or skin necrosis occurred in all cases. Skin defects closed directly after continuously stretching for 7-18 days. No skin graft or free flap repair was performed in all patients. The wound healed well after operation. All the 10 patients were followed up 5-8 months (mean, 6.5 months). There was no necrosis around the wound margin and the scar was linear. The sensation and function were not affected.ConclusionDelayed skin-stretching device is an effective method to treat skin and soft tissue defects, which has the advantages of simple operation, lower risk of operation, less complications, and reliable effectiveness.

关键词: 皮肤软组织缺损; 延时皮肤牵拉器; 皮肤牵张法

Key words: Skin and soft tissue defect; delayed skin-stretching device; skin stretching

引用本文: 宋文吉, 苑博, 赵正南, 童致虹, 梁海东. 延时皮肤牵拉器在皮肤软组织缺损治疗中的应用. 中国修复重建外科杂志, 2018, 32(10): 1281-1285. doi: 10.7507/1002-1892.201804050 复制

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