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Regis Ernest Mendame Ehya Yong Zhao Xun Zheng Wanrong Yi Guy-Armel Bounda Zonghuan Li Weidong Xiao Aixi Yu 《Journal of tissue viability》2017,26(4):282-288
Background
Perforator flap techniques with conventional wound dressing have being extensively used in the management of soft-tissue defects. However; the flap's survival rate is not always guaranteed and the wound healing time always long. The aim of this study was to investigate the clinical effectiveness use of a freshly transplanted perforator flap in conjunction with Vacuum-assisted closure (VAC) for better clinical outcomes.Methods
A prospective, randomized, effectiveness study comparing the clinical outcomes of VAC versus traditional wrap and bandages for the treatment of open wounds that required hospital admission and operative debridement using perforator flaps, was carried out from March 1, 2014 to March 31, 2016 at Wuhan University Zhongnan Hospital. Fifty-one eligible patients were randomized into two groups; study group (perforator flaps covered by VAC) and control group (perforator flaps covered by traditional wrap and bandages). The measured clinical endpoints included the time of the first post-operative dressing change, pain visual analogical scale, perforator flap infection rate, 95% perforator flap healing time and percentage of survived perforator flap.Results
There was no statistically significant difference in the demographic profiles in the two cohorts. There were statistically significant differences in the clinical endpoints in the two groups (p < 0.001; p < 0.05, Table 2).Conclusions
In summary, VAC combining with perforator flap technique, can diminish accumulated exudation of the transferring flap, protect against postoperative infection, prolong the interval between perforator flap relocation and first postoperative dressing change, decrease pain during removal of dressing, increase perforator flap survival rate, and shorten wound healing time, with a good aesthetic outcome, a good mobility and a satisfactory therapeutic result. 相似文献2.
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口服华法林可用于预防和治疗动静脉血栓形成和栓塞,但由于华法林治疗指数窄,需要认真监测以达治疗目标。本研究旨在观察和评估两种不同剂量华法林治疗方案在中国患者中的疗效。查阅2008年9月至2009年12月心脏瓣膜手术患者的病历,筛选手术后第一天就开始使用华法林治疗的368名患者,采用交叉设计方案,对患者进行随机分组,以国际标准化比值(INR)反映抗栓治疗结果详情。两组患者住院期间分别接受两种不同规格(中国2.5mg,美国3mg)华法林抗凝治疗,对其抗凝结果进行统计学分析,以评价预测INR治疗范围的因素。患者的平均年龄为(48.23±12.96)岁。2.5mg组患者INR在治疗范围的比例低于3mg组(35.17%,47.72%),两者具有显著性差异(P=0.032<0.05)。研究显示INR目标范围1.8–2.2和2.0–2.5之间有显著关联,统计学分析显示各自P值为0.031和0.025。两组患者在治疗期间有显著性差异。大部分患者都需要终生治疗(P=0.035)。统计学研究表明,规格3.0mg华法林较2.5mg华法林更优。在不同治疗期间应尽可能简化治疗方案。 相似文献
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