高分子泡沫材料负压封闭引流修复足踝部皮肤软组织缺损

背景：有研究表明，对于开放性骨折伴软组织缺损在不可能关闭软组织缺损和未找到可用的肌肉和肌皮瓣前，将负压封闭引流高分子泡沫材料作为人工替代皮肤覆盖创面是一种较好的方法。目的：观察高分子泡沫材料负压封闭引流修复足踝部皮肤软组织缺损的疗效。方法：选择25例足踝部皮肤软组织缺损患者，其中14例采用高分子泡沫材料负压封闭引流技术联合拉网植皮治疗，另11例采用传统换药联合植皮打包覆盖创面治疗。比较两组治疗的临床效果差异。结果与结论：负压封闭引流组中10例植皮完全成活，成活率为71%；另4例通过换药最终覆盖创面。传统换药组中6例植皮完全成活，成活率为55%；剩余5例中3例通过换药愈合，2例行二次植皮。两组植皮成活率差异无显著性意义（P 〉0.05）。负压封闭引流组等待二期手术时间、二期手术前换药次数及缺损完全修复时间均少于传统换药组（P 〈0.05）。提示高分子泡沫材料负压封闭引流技术可加快游离植皮修复足踝部皮肤软组织缺损创面愈合速度，缩短病程。

Vacuum sealing drainage based on wound surface dressing biomaterials for repairing soft tissue defects of the foot and ankle

BACKGROUND：Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation. OBJECTIVE：To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle. METHODS：Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION：The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finaly cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them stil needed skin graft operation once more. The total survival rate between the two groups has no statistical significance（P 〉 0.05）. The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statisticaly different （P 〈 0.05）. So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.