【摘要】 目的探讨封闭负压吸引在腹部带蒂真皮下血管网皮瓣修复手热压伤的临床应用中,促进皮瓣与创面愈合的作用机制。方法选择42例手部严重热压伤患者行腹部带蒂真皮下血管网皮瓣修复创面,随机分成实验组和对照组,每组21例。实验组皮瓣转移后,在皮瓣下均匀放置3～6根硅胶管(直径0.2cm,带侧孔6～8个),各管另一端穿出皮瓣两侧集中成一束,连接中心负压吸引(压力0.02～0.06MPa),皮瓣边缘以医用粘贴手术巾封闭。对照组常规皮瓣转移缝合,皮瓣下放置1条橡皮引流条。两组术后,适当加压包扎创面,72小时拔出引流管(条)。术后第5天开始皮瓣蒂部阻断血运训练,皮瓣阻断1h以上无血运障碍后实施断蒂手术。观察两组皮瓣的成活率及断蒂时间,所获数据采用完全随机化设计法进行分析,组间比较分别采用χ2检验和t检验。结果实验组皮瓣100%成活率16例,98%～99%成活率5例,对照组皮瓣100%成活率8例,98%～99%成活率13例;实验组平均的断蒂时间为(10.4±2.4)天,对照组则为(15.0±5.3)天。实验组皮瓣成活率明显高于对照组(P<0.05),断蒂时间也较对照组缩短(P<0.01)。结论封闭负压吸引在腹部带蒂真皮下血管网皮瓣修复手部热压伤的应用中,可促进皮瓣与创面愈合,提高皮瓣的成活率及缩短断蒂时间。更多还原

【Abstract】 Objective To investigate the action mechanism of using vacuum-sealing-drainage in pedicled abdominal flap with subdermal vascular net to repair pressure thermo injury of hand for clinical application.Methods Forty-two patients were divided randomly into experimental and control group,each with 21 patients.The experimental group was treated with vacuum-sealing-drainage after transfer of skin flap,and the control group was treated with a rubber drainage after transfer of skin flap.After 5 days,the training of blocking up blood started,and the pedicels were cut off after one hour blocking without blood disorder.The survival rate of pedicle abdominal flap and the time of severing flap were observed.The clinical data were analyzed with randomization and stratified analysis Chi-square test and t test were used for analysis.Results In the experimental group,100% survival rate was found in 16 and 90% survival rate was in 5.In the control group,100% survival rate was found in 8 and 90% survival rate was in 13.The time of severing flap for the experimental group was 10.4±2.4 days,the control group was 15.0±5.3 days.The survival rate of flap and the severing flap time in experimental group were better than that of control group.Conclusion Vacuum-sealing-drainage can improve the survival rate of pedicle abdominal flap with subdermal vascular net and shorten the severing flap time.更多还原