改良大块中厚皮片移植术治疗创伤后皮肤软组织缺损

目的探索一种简便、实用的中厚大块皮片移植术治疗创伤后较大皮肤软组织缺损的方法。方法 2004年5月～2007年7月收治各种创伤导致皮肤缺损患者33例,最大创面面积为25.0cm×15.0cm,最小为3.0cm×5.0cm大小;术中将刺有小口的自体中厚皮片直接覆盖于准备好的创面上,予以适当加压包扎并换药治疗。结果 33例患者均在2周后拆除敷料,观察显示25例患者皮片全部成活,3例皮片局部出现水疱、5例患者渗液较多,皮片呈暗紫色,经过换药皮片均在3周内成活。其中28例患者得到了3～14个月随访,术后皮片质地、色泽、弹性良好,无一例出现瘢痕挛缩导致功能障碍。结论该方法操作简便、实用,愈合率高,术后并发症少,值得推广应用。

A Modified Technique of Large Piece Intermediate-split-thickness Skin Grafting for Treating the Cutaneous and Soft Tissue Deficiency after Trauma

Objective To explore a simple,pragmatic technique of large piece intermediate-split-thickness skin grafting for treating the cutaneous and soft tissue deficiency after trauma.Methods 33 patients were treated for cutaneous and soft tissue deficiency after trauma in our division from May 2004 to July 2007.The maximal area of trauma was 25.0 cm × 15.0 cm,the minimal was 3.0 cm × 5.0 cm.During the operation the intermediate-split-thickness skin was directly covered the prepared raw surface,then the wounds were packed properly and treated by dressing change.Results 33 patients were removed dressings after 2 weeks and 25 patients with skin grafting had survived,3 patients had localized bubbles,5 patients had much effusion and the corlor of skin presented purple,but all of these intermediate-split-thickness skins had survived after changing dressing during 3 weeks.28 patients had followed up for 3～14 months,and the results showed that the corlor,texture,flexibility of the grafted skin were satisfactory,these was no cicatricial contracture occurred in any case.Conclusion The method is simple,practical;and has high healing rate,few complications,which is worth generalizing and applying.