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负压创面治疗技术联合整张中厚皮片移植修复肉芽创面
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《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

Title:: Clinical Application of Negative Pressure Wound Therapy (NPWT) Combined with
Split Thickness Skin Graft in Granulation Stage Wounds Repair

Keywords:: Key words: negative pressure wound therapy(NPWT); staging operation; split thickness skin graft; the whole piece of skingraft; repair; granulation wounds

摘要:: [摘要]目的：探讨负压创面治疗技术（Negative pressure wound therapy，NPWT）联合整张中厚皮片移植修复肉芽创面的
临床效果。方法：2015年6月-2018年2月，采用分期手术修复创面的治疗手段，一期清创后创面及空腔填塞放置负压引流系
统，封闭创面后间歇负压（300～450mmHg）引流4～16d。培育肉芽组织生长良好后，二期手术持续负压（125～150mmHg）引
流联合植皮闭合创面。结果：所有创面伤口愈合良好，疗效满意，皮片色泽弹性良好，无明显瘢痕挛缩，平均住院时间约
16.5d。1例口服羟基脲合并糖尿病溃疡患者术后2个月再次出现溃疡，停药后好转。结论：NPWT联合整张中厚皮片移植对于
肉芽创面安全有效，减少了患者住院时间，减少抗生素使用时长，减少总花费，同时其外观满意，瘢痕挛缩少，肢体功能良
好，提高了患者生活质量。

Abstract:: Abstract: Objective To investigate the clinical effect of negative pressure wound therapy (NPWT) combined with the split
thickness skin graft in patients with granulation wounds. Methods Fifty patients who attended our wound care centre between
June 2015 and February 2018 were recruited into this study. They were first treated using intermittent negative pressure (300-
450mmHg) for 4-16d after wound debridement. The wounds were then grafted with split thickness skin grafts followed by
sustenance negative pressure wound therapy of 125-150mmHg provided between 6 up to 38 months (average 22 months).
Results The findings from follow-up studies indicated that all cases in treatment group healed well, with satisfactory skin
regenerative effect normal color and good elasticity, without scarring or contracture formation. The average hospitalization time
for the majority of the patients was about 16.5 days. Only one case of a diabetic foot ulcer taking hydroxycarbamide relapsed
after post-operation. However, the wound granulation and healing improved after drug withdrawal. Conclusion NPWT
combined with the split thickness skin grafts in patients with granulation stage wounds was a safe and effective surgical method
for granulation wound healing. It did not only reduce hospitalization time and antibiotic usage time, it also showed greater costeffectiveness
as well as reduced further scarring, contracture formation, and improved quality-adjusted life for years.

[1] 张朦,韩涛,卞兰峥. VAC结合游离植皮治疗儿童大面积皮肤缺损疗效观察及对患儿生活质量的影响[J].中国美容医学,2020,(5):93.
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[3] 胡晓东,李永忠,李云飞. 负压创面治疗联合局部氧疗在小腿创面修复中的应用效果[J].中国美容医学,2020,(8):78.
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更新日期/Last Update: 2020-09-25