Masquelet technique combined with skin graft in treatment of chronic refractory wounds in elderly patients
10.3760/cma.j.cn441206-20230107-00004
- VernacularTitle:Masquelet技术结合游离植皮治疗老年慢性难愈创面的临床应用
- Author:
Feiya ZHOU
1
;
Leyi CAI
;
Xianjie LIN
;
Wenzhen ZHANG
;
Zipu HONG
;
Tingxiang CHEN
;
Mingming CHEN
;
Weiyang GAO
Author Information
1. 温州医科大学附属第二医院创面修复外科，浙江 温州 325000
- Keywords:
Chronic wounds;
Masquelet technique;
Bone exposure;
Tendon exposure;
Elderly patient;
Lower limb
- From:
Chinese Journal of Microsurgery
2023;46(4):424-429
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To introduce a surgical method and clinical effect of using Masquelet technique combined with skin graft to cover chronic refractory wounds in elderly patients.Methods:From September 2020 to September 2022, 20 elderly patients with wounds of bone or tendon exposure in lower limbs were treated in the Department of Wound Repair, the Second Affiliated Hospital of Wenzhou Medical University. Due to the age and poor general condition of the patients, flap transfer for wound coverage were not allowed. Masquelet technique was therefore applied in the treatment of chronic wounds of such patients. Sizes of wounds were found at 4.5 cm×3.0 cm to 15.0 cm×6.0 cm and all accompanied with tendon and bone exposure, after thorough debridement. Wounds were then sealed with antibiotic bone cement several times. After having induced formation of membrane in wounds, free mesh skin graft was used to cover the refractory wounds. The patients were entered in follow up regularly after surgery at outpatient service, and telephone or video reviews. The wound healing of patients and whether there were related complications in the skin donor area were observed. The number of operation times in the first stage was 1-4 with an average of 1.3 times ± 0.7 times. Lower Extremity Function Scale (LEFS) was used to evaluate the recovery of lower limb function.Results:All 20 wounds healed well. The follow-up time was 3-12 months, with an average of 7.6 months. The appearance and texture of the skin in the wounds area were satisfactory. The mean LEFS was 69.83 point ± 10.82 point.Conclusion:Using Masquelet technique combined with free skin grafting to treat refractory wounds in the elderly patients can achieve satisfactory clinical outcomes. It is a simple and reliable supplement to the wound repair, and can reduce the surgical risk.
