反植皮联合负压封闭引流治疗肢体大面积皮肤撕脱伤

目的 探讨反植皮联合应用负压封闭引流（vacuum sealing drainage，VSD）治疗肢体大面积皮肤撕脱伤的效果。方法 对近2年来收治的肢体大面积皮肤撕脱伤患者16例采用筛孔状中厚皮片反取皮原位移植法修复，皮片表面用多聚乙烯醇明胶海绵材料（商品名为“威克伤”）覆盖封闭，24小时不间断负压吸引。结果 平均使用VSD7天，12例皮片全部存活，创面愈合。4例皮片存活90％～95％，经换药后，创面愈合，患肢运动功能及外观恢复良好。结论 筛孔状中厚皮片反取皮原位移植法修复联合VSD处理肢体撕脱创面能在Ⅰ期关闭创面的同时更好地进行全创面引流，降低感染的发生，促进皮片与创面的良好贴附，有利于皮片存活，是治疗肢体撕脱伤较好的处理方法。

Treatment of large skin tear wound of limbs by reattachment of skin combined with vacuum sealing drainage

Objective To investigate the treatment effects of reattachment of skin combined with vacuum sealing drainage(VSD) on large skin tear wound of limb.Methods Sixteen cases of treated by reattachment of with sieve-pore middle-thickness skin flap,the wound surface was filled with polyvinyl alcohol foams(vacuseal),continuous negative pressure drainage was taken for 24h.Results The average time of VSD was 7 days. Twelve cases recovered completely.The flap survival rate in 4 cases was 90%~95%.Conclusion The large skin tear wound could be closed by reattaching sieve-pore middle-thickness skin flap combined with VSD,which is a crediable treatment of limbs skin-tear wound.