皮瓣移植修复与植皮联合负压引流治四肢复合组织损伤的双盲、随机比较(1)
[摘要] 目的 观察皮瓣移植修复与植皮联合负压引流治四肢复合组织损伤的双盲、随机比较。方法 整群选取2013年2月—2015年11月该院骨科收治的108例四肢复合组织损伤患者，双盲随机法分为两组各54例，对照组行皮瓣移植修复术治疗，观察组另行植皮联合负压引流术治疗，观察两组各项指标，并观察术前、后两组VAS疼痛评分比较，同时观察术后并发症发生情况。 结果 观察组下床活动时间(28.15±11.68)h较对照组显著长(P<0.05)，创面愈合时间(22.81±3.21)d、换药次数(8.45±1.23)次分别均较对照组显著短(P<0.05)；术后两组VAS评分分别均较术前显著减小，且观察组VAS评分(6.56±0.25)分、(4.26±0.36)分、(2.01±1.01)分分别均较对照组减小显著，均差异有统计学意义(P<0.05)；观察组术后并发症发生率1.85%较对照组12.96%显著低(P<0.05)。 结论 植皮联合负压引流可显著延长四肢复合组织损伤患者的下床活动时间，同时显著减少创面愈合时间、换药次数、术后VAS评分及术后并发症发生率，具有临床推广应用价值。
[关键词] 四肢复合组织损伤；负压引流；皮瓣移植修复
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2016)05(b)-0066-03
[Abstract] Objective To observe the double-blind and random comparison of skin flap grafting repair and skin-grafting combined with negative pressure drainage in treatment of extremities complex tissue damage. Methods 108 cases of patients with extremities complex tissue damage admitted and treated in the department of orthopaedics of our hospital from February 2013 to November 2015 were selected and randomly and double-blindly divided into two groups with 54 cases in each， the control group were treated with skin flap grafting repair， the observation group were treated with skin-grafting combined with negative pressure drainage， and the various indexes including the time of leaving bed， wound healing time and frequency of dressing change and the comparison in VAS pain scores before and after operation of the two groups were observed， at the same time， the occurrence of postoperative complications was observed. Results The time of leaving bed in the observation group was(28.15±11.68) h， which was obviously longer than that in the control group， P<0.05， the wound healing time and frequency of dressing change in the observation group were respectively (22.81±3.21) d and (8.45±1.23) times， which were obviously shorter than those in the control group， P<0.05， the VAS score after operation of the two groups were obviously decreased compared with those before operation， the VAS scores in the observation group were respectively (6.56±0.25) marks， (4.26±0.36) marks and (2.01±1.01) marks， and the decreases of the VAS scores in the observation group were more obvious that those in the control group with statistical significance， P<0.05， and the incidence rate of postoperative complications in the observation group was obviously lower than that in the control group， (1.85% vs 12.96%)， P<0.05. Conclusion Skin-grafting combined with negative pressure drainage can obviously prolong the time of leaving bed in patients with extremities complex tissue damage， at the same time， obviously decrease the wound healing time， frequency of dressing change， postoperative VAS score and incidence rate of postoperative complications， which is worth clinical promotion and application. (林仙德)
[关键词] 四肢复合组织损伤；负压引流；皮瓣移植修复
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2016)05(b)-0066-03
[Abstract] Objective To observe the double-blind and random comparison of skin flap grafting repair and skin-grafting combined with negative pressure drainage in treatment of extremities complex tissue damage. Methods 108 cases of patients with extremities complex tissue damage admitted and treated in the department of orthopaedics of our hospital from February 2013 to November 2015 were selected and randomly and double-blindly divided into two groups with 54 cases in each， the control group were treated with skin flap grafting repair， the observation group were treated with skin-grafting combined with negative pressure drainage， and the various indexes including the time of leaving bed， wound healing time and frequency of dressing change and the comparison in VAS pain scores before and after operation of the two groups were observed， at the same time， the occurrence of postoperative complications was observed. Results The time of leaving bed in the observation group was(28.15±11.68) h， which was obviously longer than that in the control group， P<0.05， the wound healing time and frequency of dressing change in the observation group were respectively (22.81±3.21) d and (8.45±1.23) times， which were obviously shorter than those in the control group， P<0.05， the VAS score after operation of the two groups were obviously decreased compared with those before operation， the VAS scores in the observation group were respectively (6.56±0.25) marks， (4.26±0.36) marks and (2.01±1.01) marks， and the decreases of the VAS scores in the observation group were more obvious that those in the control group with statistical significance， P<0.05， and the incidence rate of postoperative complications in the observation group was obviously lower than that in the control group， (1.85% vs 12.96%)， P<0.05. Conclusion Skin-grafting combined with negative pressure drainage can obviously prolong the time of leaving bed in patients with extremities complex tissue damage， at the same time， obviously decrease the wound healing time， frequency of dressing change， postoperative VAS score and incidence rate of postoperative complications， which is worth clinical promotion and application. (林仙德)