Clinical study of thinning and replanting combined with VAC negative pressure drainage in the treatment of large area of retrograde skin avulsion injury
10.3760/cma.j.cn431274-20201229-01755
- VernacularTitle:打薄回植联合创面负压引流治疗大面积逆行皮肤撕脱伤的临床研究
- Author:
Yanjun LI
1
;
Xiping ZHANG
;
Hong XU
;
Meiquan HUANG
Author Information
1. 湖南株洲市中心医院创伤骨科 412007
- Keywords:
Skin transplantation;
Transplantation, autologous;
Negative-pressure wound therapy;
Skin avulsion injury;
Joint function
- From:
Journal of Chinese Physician
2021;23(10):1542-1545
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the clinical effect of thin replantation combined with vacuum assisted closure (VAC) in the treatment of large area retrograde skin avulsion injury.Methods:A total of 42 patients with large scale retrograde skin avulsion injury admitted to the trauma center of Zhuzhou Central Hospital from April 2017 to April 2019 were enrolled in this study, and were treated with VAC continuous negative pressure drainage after operation. The wound survival rate, wound survival area, wound infection, replantation skin performance and joint mobility were observed.Results:All of the 42 patients were followed up for 8-50(23.56±3.56)months. 35 patients survived the stage 1 skin grafting, the skin flap survived, and the wound had no obvious skin defect. After active dressing change, the wound healed well, and no second operation was needed. Small area necrosis occurred in the first stage wound of 7 patients due to large skin defect, and the wound healed well after the second stage surgical transplantation and enhanced dressing change. The Hospital for Special Surgery (HSS) score of 26 patients was 80-95(87.96±3.21), and the American Orthopaedic Foot and Ankle Society (AOFAS) score of 22 patients was 80-96(88.79±3.41). All patients had good skin sensation, elasticity, pressure resistance, wear resistance and color, and joint mobility was good without obvious limitation of movement.Conclusions:Thinning replantation combined with VAC negative pressure drainage in the treatment of large area retrograde skin avulsion injury can significantly promote the application of wound surface and skin graft, which is conducive to drain the drainage fluid out of the body, reduce the wound infection rate, improve the survival rate of skin grafting and improve joint function.
