[1]李明霞.VAC联合植皮修复儿童下肢大面积皮肤缺损[J].中国美容医学,2022,(6):74-77.
　LI Mingxia.Clinical Effect of VAC Combined with Skin Grafting in Repairing Large Skin Defects of Lower Limbs in Children[J].Medical Aesthetics and Beauty,2022,(6):74-77.
点击复制

VAC联合植皮修复儿童下肢大面积皮肤缺损()
分享到：

《中国美容医学》[ISSN:1008-6445/CN:61-1347/R]

卷:
期数:
2022年6期
页码:
74-77
栏目:
出版日期:
2022-06-10

文章信息/Info

Title:
Clinical Effect of VAC Combined with Skin Grafting in Repairing Large Skin Defects of Lower Limbs in Children
文章编号:
1008-6455（2022）06-0074-04
作者:
李明霞
(南京医科大学附属儿童医院烧伤整形科 江苏 南京 210000)
Author(s):
LI Mingxia
(Department of Burn and Plastic Surgery,Childrens Hospital of Nanjing Medical University,Nanjing 210000,Jiangsu,China)
关键词:
负压封闭引流; 植皮; 皮肤缺损; 创面修复; 下肢; 儿童
Keywords:
vacuum-assisted closure(VAC);  skin grafting;  skin defect;  wound repair;  lower limbs;  children
分类号:
R622
文献标志码:
A
摘要:
目的：观察负压封闭引流（Vacuum-assisted closure，VAC）联合植皮手术对儿童下肢大面积皮肤缺损的修复效果。方法：2017年1月-2020年1月笔者医院收治的76例下肢大面积皮肤缺损患儿，按照随机数字表法分为对照组和观察组，每组38例。对照组采用植皮手术，观察组在对照组基础上联合VAC治疗。比较两组创面修复效果、临床指标、疼痛程度及感染情况。结果：手术6个月后，观察组创面修复优良率高于对照（84.21% vs 63.16%），差异具有统计学意义（P＜0.05）。术后，观察组植皮存活时间、换药次数、住院天数及瘢痕评估量表（Patient and observer scar assessment scale，POSAS）均少于对照组，皮片存活率高于对照组（81.58% vs 65.79%），差异均具有统计学意义（P＜0.05）。术后1周，观察组血小板衍生生长因子（Platelet derived growth factor，PDGF）表达水平高于对照组，血管内皮生长因子（Vascular endothelial growth factor，VEGF）低于对照组，差异具有统计学意义（P＜0.05）。手术2个月后，观察组中文版儿童疼痛行为量表（The face, legs, activity, cry, consolability behavioral tool，FLACC）各项评分低于对照组，差异具有统计学意义（P＜0.05）。观察组不良反应总发生率低于对照组（15.79% vs 31.58%），差异具有统计学意义（P＜0.05）。结论：VAC联合植皮手术修复儿童下肢大面积皮肤缺损效果较佳，其创面修复效果较好，美观度较高，利于术后恢复，缓解疼痛，可有效降低不良反应，值得临床推广。
Abstract:
Objective To observe the clinical eff ect of vacuum-assisted closure (VAC) combined with skin grafting on children with lower limb large-area skin defects. Methods 76 children with lower limb large-area skin defects admitted to the hospital between January 2017 and January 2020 were divided into the control group and the observation group according to the random number table method, with 38 cases in each group. The control group was given skin grafting, and the observation group was combined with VAC treatment on the basis of the control group. The wound repair eff ect, clinical indicators, pain degree and infection status of the two groups were compared. Results Six months after operation, the excellent and good rate of wound repair in the observation group was higher than that in the control group (84.21% vs 63.16%), and the diff erence was statistically signifi cant (P＜0.05). After operation, the survival time, dressing change times, hospital stay and POSAS score of skin grafting in the observation group were shorter than those in the control group, and the survival rate of skin grafting in the observation group was higher than that in the control group (81.58% vs 65.79%, P＜0.05). One week after operation, the expression level of PDGF in the observation group was higher than that in the control group, and the level of VEGF was lower than that in the control group (P＜0.05). Two months after operation, the FLACC scores of the observation group were lower than those of the control group (P＜0.05). The total incidence of adverse reactions in the observation group was lower than that in the control group (15.79% vs 31.58%，P＜0.05). Conclusion VAC combined with skin grafting has a better eff ect in repairing large skin defects of children’s lower limbs. Its wound repair eff ect is good and its aesthetics is high. It is conducive to postoperative recovery, relieve pain, and eff ectively reduce adverse reactions. It is worthy of clinical promotion

相似文献/References:

[1]孙同祖. 植皮联合负压封闭引流技术修复深度烧伤创面的应用观察及并发症分析[J].中国美容医学,2018,(04):4.
　SUN Tong-zu. Application of Skin Grafting Combined with Negative Pressure Closed Drainage for Deep Burn Wounds and Analysis of its Complications[J].Medical Aesthetics and Beauty,2018,(6):4.
[2]雷 磊,高 优,许建允,等. 游离植皮联合负压创面治疗技术治疗Ⅲ/Ⅳ度烧伤创面效果分析[J].中国美容医学,2018,(07):20.
　LEI Lei,GAO You,XU Jian-yun,et al. Application of Free Skin Grafting Combined with Negative Pressure Wound Therapy in the Treatment of Ⅲ/Ⅳ Degree Burns Wounds[J].Medical Aesthetics and Beauty,2018,(6):20.
[3]白燕玲,冯艳玲,邓小芬. 结构化管理模式在小腿皮肤软组织撕脱伤VSD干预中的应用[J].中国美容医学,2019,(05):154.
　BAI Yan-ling,FENG Yan-ling,DENG Xiao-fen. Application of Structured Management Model in VSD Intervention for Skin and Soft Tissue Avulsion Injury of Leg[J].Medical Aesthetics and Beauty,2019,(6):154.
[4]孟红阳,杨新蕾,张新合,等. 负压封闭引流技术结合肌瓣转移游离植皮在面部难愈性创面修复中的应用[J].中国美容医学,2019,(12):22.
　MENG Hong-yang,YANG Xin-lei,ZHANG Xin-he,et al. Vacuum Sealing Drainage Combined with Free Skin Grafting of Muscle Flap Transferto Repair the Refractory Facial Wounds[J].Medical Aesthetics and Beauty,2019,(6):22.
[5]熊清华,刘 诚,李小林,等. 局部筋膜瓣联合植皮在头面部骨外露创面修复中的应用[J].中国美容医学,2020,(4):68.
　XIONG Qing-hua,LIU Cheng,LI Xiao-lin,et al. Application of Local Fascial Flap and Skin Grafting in the Repair of Bone ExposedWounds of Head and Face[J].Medical Aesthetics and Beauty,2020,(6):68.
[6] 米增法. 下腹部带蒂超薄皮瓣修复术联合负压封闭引流治疗手部热压伤[J].中国美容医学,2020,(9):74.
　 MI Zeng-fa. Observation on the Curative Effect of Pedicled Ultra-thin Flap Repair of the LowerAbdomen Combined with Vacumm Sealing Drainage Technique in the Treatment ofHot Pressure Injury of Hand[J].Medical Aesthetics and Beauty,2020,(6):74.
[7] 梁 云,张国安. 亲水性纤维含银敷料联合负压封闭引流对深Ⅱ度烧伤创面愈合及VEGF的影响[J].中国美容医学,2020,(11):38.
　 LIANG Yun,ZHANG Guo-an. Effect of Hydrophilic Fiber Silver Dressing Combined with Vacuum Sealing Drainageon Wound Healing and VEGF in Patients with Deep Second Degree Burn[J].Medical Aesthetics and Beauty,2020,(6):38.
[8] 王洁瑜,杨 阳,陆兰云. 综合护理干预在负压封闭引流治疗撕裂伤创面中的应用[J].中国美容医学,2021,(2):163.
　 WANG Jie-yu,YANG Yang,LU Lan-yun. Application of Comprehensive Nursing Intervention in the Treatment of LaceratedWound with Vacuum Sealing Drainage[J].Medical Aesthetics and Beauty,2021,(6):163.
[9] 李 晴,于文君,刘鹏程,等. 自体皮肤回植联合负压封闭引流修复皮肤撕脱伤的疗效及影响因素分析[J].中国美容医学,2021,(9):41.
　 LI Qing,YU Wen-jun,LIU Peng-cheng,et al. Analysis of Curative Effect and Influencing Factors of Autologous Skin ReplantationCombined with Vacuum Sealing Drainage to Repair Skin Avulsion Injury[J].Medical Aesthetics and Beauty,2021,(6):41.
[10]徐 敏,郭忠梁,罗长生.局部氧疗联合负压封闭引流治疗皮肤深Ⅱ度损伤的疗效探讨[J].中国美容医学,2022,(5):53.
　XU Min,GUO Zhongliang,LUO Changsheng.Effect of Topical Oxygen Therapy Combined with Vacuum Sealing Drainage in the Treatment of Deep Second-degree Skin Injury[J].Medical Aesthetics and Beauty,2022,(6):53.
[11]黄祖根,吴杉英,雷 忱. 清创术联合负压封闭引流技术治疗糖尿病足创面的临床观察[J].中国美容医学,2018,(12):36.
　HUANG Zu-gen,WU Shan-ying,LEI Chen. Observation of Debridement Combined with Vacuum Sealing Drainage in Treating Diabetic Foot Wounds[J].Medical Aesthetics and Beauty,2018,(6):36.

更新日期/Last Update: 2022-07-01