Clinical study of skin grafting in small wounds with anastomotic vascular exposure: report of 16 cases
10.3760/cma.j.issn.1001-2036.2019.06.005
- VernacularTitle: 在有吻合血管裸露的小创面植皮16例的临床观察
- Author:
Yitao WEI
1
;
Xiongjun MEI
1
;
Renjuan WU
1
;
Guiwu ZHONG
2
;
Haihua LIANG
1
;
Fangqin SUN
1
Author Information
1. Department of Hand and Foot Microsurgery, Chang’an Xin’an Hospital, Dongguan, Guangdong Province 523800, China
2. Department of Orthopedic, Hospital Attached to Aero Medicine Iinstitute of PLA, Beijing 100089, China
- Publication Type:Journal Article
- Keywords:
Full-thickness skin graft;
Skin grafting;
Anastomotic Vascular exposed;
Wound;
Repairing
- From:
Chinese Journal of Microsurgery
2019;42(6):536-539
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To report the clinical effect of skin grafting in small wounds with exposed vascular anastomosis.
Methods:From January, 2011 to May, 2018, 16 small wounds with anastomotic vascular exposure were treated by full-thickness skin grafting. Of which, 4 performed after replantation, 9 after reconstruction and 3 after flap transplantation. Thirteen wounds were on hand and 3 in foot. After anastomosing the vessels, 3 arterial anastomoses, 9 venous anastomoses and 4 arterial-and-venous anastomoses were left exposure in wounds. Sizes of artery exposed in wound were 0.8 to 2.3 mm with an average of 1.0 mm. Sizes of vein exposed in wound were 0.8 to 2.5 mm with an average of 1.2 mm. The areas of soft tissue defect were 1.0 cm×1.5 cm to 2.6 cm×6.0 cm, and the areas of grafted skins were 1.0 cm×1.5 cm to 2.6 cm×6.0 cm. Grafted skin were covered without package nor pressurization. Donor areas were directly sutured. Postoperative follow-up was conducted to observe the postoperative effect.
Results:Fourteen grafted skin completely survived, one partially survived and healed after immobilization of the limb and change of dressing, and one developed necrosis. All patients were followed-up for 6-24 months (mean 14.4 months). CDU, HHD or CTA were used at the final follow-up. Vascular anastomoses were patency in 15 patients, and 1 patient had embolism developed. No pigmentation was found on the grafted skin. All grafted skin was soft and wearable with two point discrimination at 7-10 mm. The pulse of anastomotic artery could be felt on the grafted skins. Only linear scars were left in the donor sites.
Conclusion:The operation of full-thickness skin grafting in small wounds with exposed vascular anastomosis was easy to perform and with high survival rate. The effect of operation is satisfactory. The exposure of anastomosed vessels does not affect the patency of anastomotic vessels, and has considerable clinical values.
