标题：负压封闭引流技术在下肢大面积皮肤撕脱伤治疗中的应用

      作者：罗东斌，焦 锋，张文佳
    (广州市中西医结合医院骨外科，广东 广州 510800)

      卷次： 2014年25卷2期

      【摘要】 目的 探讨负压封闭引流技术在下肢大面积皮肤撕脱伤治疗中的疗效。方法 采用反取皮全
厚、中厚皮片和真皮下血管网皮瓣原位植皮联合负压封闭引流技术治疗下肢大面积皮肤撕脱伤患者 24例。
结果 16例患者创面一期封闭，6例发生小范围皮片坏死，经换药后愈合，2例皮片坏死较大者经过二次邮票植
皮完全愈合。所有患者均获随访，随访时间6~36个月，平均24个月。保留真皮下血管网皮瓣原位植皮者肢体外
观色泽接近正常，弹性及感觉功能较好，关节功能良好；全厚及中厚皮片原位植皮者有少量瘢痕增生，功能恢复
满意。本组未发生骨、关节及软组织感染等并发症。结论 下肢大面积皮肤撕脱伤植皮后应用负压封闭引流技
术，可有效控制感染，促进皮片与创面贴附，有利于皮片存活，值得临床推广应用。

      【关键词】 大面积皮肤撕脱伤；原位植皮术；负压封闭引流

      【中图分类号】 R64 【文献标识码】 A 【文章编号】 1003—6350（2014）02—0252—03


Application of vacuum sealing drainage in the treatment of large skin avulsion of lower extremities.
LUO Dong-bin,
JIAO Feng, ZHANG Wen-jia. Department of Orthopaedics, Guangzhou Hospital of Integrated Traditional and West Medicine,
Guangzhou 510800, Guangdong, CHINA

【Abstract】 Objective To investigate the efficacy of vacuum sealing drainage in the treatment of large skin avul-
sion of lower extremities. Methods The anti-take the skin thickness in the skin graft and subdermal vascular network flap
in situ graft joint vacuum sealing drainage were performed in the treatment of 24 patients with skin of lower limbs avul-
sion. Results Sixteen patients suffered a closed wound; 6 suffered small skin graft necrosis and were cured after
changing dressing; 2 suffered skin flap necrosis and were healed completely after the second stamp skin graft. All pa-
tients were followed up for 6 to 36 months, with an average of 24 months. The subdermal vascular network flap in situ
graft limb had appearance and color close to normal, with good flexibility and joint function; situ skin grafting of
full-thickness skin graft had a small amount of scar, and functional recovery was satisfactory. No bones, joints and
soft tissue infections and other complications occured. Conclusion Vacuum sealing drainage can effectively control
the infection, and promote skin grafts and wound attached in the treatment of the skin of lower limbs avulsion, which
is good for the survival of skin grafts.

      【Key words】 Extremity skin avulsion; In situ skin grafting; Vacuum sealing drainage