自体刃厚头皮联合负压封闭引流技术回植中厚供皮区的临床应用
The clinical application of autologous split-thickness scalp combined with vacuum-assisted-closure technique on replanting partial-thickness donor site
目的:探讨刃厚头皮联合负压封闭引流技术回植中厚供皮区的临床应用效果。方法选择2013年8月至2014年10月解放军沈阳军区总医院收治的严重烧伤愈合后面部或关节部增生、挛缩性瘢痕患者20例,行功能部位的增生性瘢痕切除,应用非功能部位的大张中厚或厚中厚皮片修复,供区自体刃厚头皮回植并联合负压封闭引流技术固定、引流。结果20例患者非功能部位中厚或厚中厚皮片供区经刃厚头皮片回植后5~7 d完全愈合,未见明显瘢痕增生。经随访半年至2年,均未见有明显的瘢痕增生,仅有部分色素沉着。刃厚头皮供区无瘢痕形成,毛发生长良好。结论中厚供皮区回植自体刃厚头皮,可加速创面愈合,减少瘢痕形成,联合负压封闭引流技术可形成密闭环境,有利于防止感染及充分引流,并使回植皮片固定牢靠,成活率高。值得临床推广应用。
更多ObjectiveTo investigate the clinical effect of conbining autologous split-thickness scalp with vacuum-assisted-closure technique on replantating partial-thickness donor site.Methods From August 2013 to October 2014,20 cases who recovered from severely burned but had both face/joint hyperplasia and contractive scar were chosen in the General Hospital of Shenyang Military Region, resecting hypertrophic scar in functional region which was recovered by big skin partial-thickness or thick split-thickness skin of non-functional region, conbining autologous split-thickness scalp with vacuum-assisted-closure technique to fix and drainage.ResultsAll the 20 cases were completely recovered in 5 to 7 days after replantation of split-thickness scalp in donation region,and there is no obvious hypertrophic scar in 2 years but some pigmentation. No scar was found in split-thickness scalp donation region,and the hair grew well.ConclusionReplantate autologous split-thickness scalp in partial-thickness donor site not only can accelerate the recover speed of the wound but also can reduce the scare, vacuum-assisted-closure technique can form an enclosed environment,prevente infection,drain fully,fix raplantation well,increase survival rate.So, the conbined autologous split-thickness scalp with vacuum-assisted-closure technique is worth popularizing in clinic.
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