自体皮片游离植皮术在难愈性创面治疗中的疗效观察

Efficacy of autologous free skin graft in the treatment of refractory wound

摘要:

目的：观察自体皮片游离植皮术在难愈性创面中的应用效果和价值。方法：选择难愈性创面患者352例，经创面处理，基础病治疗，全身支持治疗，创面肉芽新鲜后，视创面部位行自体表层皮片联合中厚皮片游离植皮术，用烧伤敷料加压包扎。结果：352例患者，322例行一期清创植皮，30例行一期清创、二期植皮，其中340例植皮后超过90%皮片存活，创面愈合或接近愈合后出院，12例植皮后有小于1/3~1/2皮片未成活，经换药或补植后，创面愈合出院，平均住院时间（16±2） d，术后平均愈合时间（19±3） d。结论：自体皮片游离植皮术有助于难愈性创面愈合或提高存活率。

Abstract:

Objective：To observe the efficacy and value of applying autologous free skin graft in the treatment of refractory wound. Methods：Totally 352 patients with refractory wound were selected. Wound treatment，basic disease treatment and systemic support were performed until the granulation became fresh. Autologous free skin graft（the surface layer and middle thick layer） was provided according to parts of the wound. Pressure dress was followed soon by using burn dressing. Results：Among the 352 cases，322 under－went stageⅠdebridement and skin graft，30 underwent stageⅠdebridement and stageⅡskin graft. Among 340 cases of skin graft，90% flaps were survived postoperatively. Twelve cases had less than 1/3-1/2 flaps died，however，the wound was healed and the patients were discharged by dressing or replanting. Average hospital duration was （16 ± 2） d，and average postoperative recovery time was （19 ± 3） d. Conclusion：Autologous free skin graft can promote the recovery of refractory wound and improve the survival rate.