湿润烧伤膏与皮瓣移植序贯治疗足踝部软组织缺损感染伴骨外露效果观察

目的探讨湿润烧伤膏与皮瓣移植序贯治疗足踝部软组织缺损感染伴骨外露的临床疗效。方法对2015年1月至2018年1月武警黑龙江省总队医院收治的26例足踝部软组织缺损感染伴骨外露患者的局部创面实施湿润烧伤膏与皮瓣移植序贯治疗,观察治疗效果。结果皮瓣移植术后,20例患者移植皮瓣完全成活,创面一期愈合,无张力性水疱、肿胀、静脉回流障碍、感染等并发症发生;6例患者移植皮瓣边缘部分坏死,予以湿润烧伤膏换药治疗后愈合。随访0.5～3.5年[(1.5±0.5)年],移植皮瓣柔软有弹性,足踝部功能恢复良好,无局部发凉等异常感觉。结论湿润烧伤膏与皮瓣移植序贯治疗足踝部软组织缺损感染伴骨外露,可有效促进创面肉芽组织生长及创面一期愈合,疗效满意。

Observation on the Clinical Efficacy of Sequential Therapy of MEBO and Skin Flap Transplantation in Treating Foot and Ankle Soft Tissue Defect Infection Combined with Bone Exposure

Objective To explore the clinical effect of the sequential therapy of MEBO and skin flap transplantation in the treatment of foot and ankle soft tissue defect infection combined with bone exposure. Methods Twenty-six patients with foot and ankle soft tissue defect infection combined with bone exposure, admitted to Heilongjiang Provincial Armed Police Corps Hospital from January 2015 to January 2018, were given the sequential therapy of MEBO and skin flap transplantation. The treatment effect was observed. Results After the skin flap transplantation, the skin flaps fully survived in 20 patients, and the wounds realized primary healing. No complications such as tension blisters, swelling, venous reflux disorder or infection were observed in these 20 patients. The marginal part of the transplanted flaps became necrotic in 6 patients, and the wounds were healed after dressing changes with MEBO. During 0.5 - 3.5 years of followup [ (1.5 ± 0.5) years], the transplanted flaps showed good elasticity, foot and ankle functions recovered well, and no abnormal sensations including local cold was observed. Conclusion The sequential therapy of MEBO and skin flap transplantation in treating foot and ankle soft tissue defect infection combined with bone exposure can promote the growth of granulation tissues and the primary healing, presenting satisfying clinical efficacy.