| 不同皮肤牵张闭合器治疗皮肤软组织缺损的临床研究 |
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投稿时间：2019-08-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 胡炜 |
HU Wei |
中国人民解放军联勤保障部队第九〇八医院骨科, 江西 南昌 330002 |
Department of Orthopaedics, the 908 th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China |
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| 邵银初 |
SHAO Yin-chu |
中国人民解放军联勤保障部队第九〇八医院骨科, 江西 南昌 330002 |
Department of Orthopaedics, the 908 th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China |
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| 李浩 |
LI Hao |
中国人民解放军联勤保障部队第九〇八医院骨科, 江西 南昌 330002 |
Department of Orthopaedics, the 908 th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China |
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| 单记春 |
SHAN Ji-chun |
中国人民解放军联勤保障部队第九〇八医院骨科, 江西 南昌 330002 |
Department of Orthopaedics, the 908 th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China |
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| 杨红 |
YANG Hong |
中国人民解放军联勤保障部队第九〇八医院骨科, 江西 南昌 330002 |
Department of Orthopaedics, the 908 th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China |
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| 双峰 |
SHUANG Feng |
中国人民解放军联勤保障部队第九〇八医院骨科, 江西 南昌 330002 |
Department of Orthopaedics, the 908 th Hospital of Chinese PLA Joint Logistics Support Force, Nanchang 330002, Jiangxi, China |
shuangfeng_2000@163.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第11期，第1021-1025页 |
| DOI：10.3969/j.issn.1003-0034.2019.11.009 |
| 基金项目:国家自然科学基金资助项目（编号：81660377）；江西省自然科学基金资助项目（编号：20171BAB205032） |
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中文摘要:
目的：比较托氏皮肤牵张闭合器（tension-relief system，TRS）和自制简易式皮肤牵张带治疗创伤所致皮肤软组织缺损的临床疗效。
方法：回顾性分析2015年6月至2016年10月创伤所致皮肤软组织缺损并行皮肤牵张器治疗的41例患者，男28例，女13例，年龄22~64（43.2±10.4）岁。根据治疗方法不同分为两组，其中采用托氏皮肤牵张闭合器治疗18例，男11例，女7例；年龄22~61（41.7±9.5）岁；缺损部位，上肢5例，下肢11例，背部2例；缺损面积42~160（78.6±17.4）cm2。自制皮肤牵张器治疗23例，男17例，女6例；年龄25~64（44.4±12.7）岁；缺损部位，上肢6例，下肢13例，背部4例；缺损面积54~175（75.2±14.3）cm2。比较两组患者创面Ⅰ期闭合情况、术中出血量、手术时间、创面愈合时间、手术并发症等情况，并采用视觉模拟评分法（visual analogue scale，VAS）评估疼痛缓解程度，采用温哥华瘢痕量表（vancouver scar scale，VSS）评定术后瘢痕恢复情况。
结果：41例患者均得到随访，时间3~12（6.2±3.7）个月。两组患者术中出血量、手术时间比较差异无统计学意义（P>0.05）。TRS组Ⅰ期直接闭合16例，创面愈合时间≤3周16例，VAS评分（3.9±1.1）分，VSS评分（3.5±1.2）分，并发症1例；自制皮肤牵张器组Ⅰ期直接闭合12例，创面愈合时间≤ 3周9例，VAS评分（4.8±1.4）分，VSS评分（5.3±1.6）分，并发症9例；两组比较差异有统计学意义（P<0.05）。
结论：TRS较自制皮肤牵张器闭合器治疗创面效果好，损伤小，愈合时间短，手术疼痛小，创面愈合美观和并发症少。 |
| 【关键词】软组织损伤 皮肤 牵张感受器 病例对照研究 |
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| Different skin-stretching devices for the treatment of skin and soft tissue defects |
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ABSTRACT
Objective: To compare clinical effects of tension-relief system(TRS) and self-made skin-stretching devices in treating skin and soft tissue defects caused by trauma.
Methods: Totally 41 patients with skin and soft tissue defects caused by trauma treated by skin-stretching devices were retrospectively analyzed from June 2015 to October 2016,including 28 males and 13 females,aged from 22 to 64 years old with an average of(43.2±10.4) years old. The patients were divided into two groups according to therapeutic methods,18 patients were treated by TRS,including 11 males and 7 females,aged from 22 to 61 years old with an average of (41.7±9.5) years old;5 patients injured on the upper limb,11 patients on lower limb and 2 patients on the back;the area of defect ranged from 42 to 160 cm2 with an average of(78.6±17.4) cm2. Twenty-three patients were treated by self-made skin stretching device,included 17 males and 6 females,aged from 25 to 64 years old with an average of (44.4±12.7) years old;6 patients injured on the upper limb,13 patients on lower limb and 4 patients on the back;the area of defect ranged from 54 to 175 cm2 with an average of(75.2±14.3) cm2. Primary closure at stageⅠ,blood loss,operation time,healing time of wound,complications between two groups were compared,VAS score was used to evaluate pain relief,vancouver scar scale(VSS) was used to assess recover of postoperative scars.
Results: Forty-one patients were followed up ranged from 3 to 12 months with an average of(16.2±3.7) months. There were no significant difference between two groups in blood loss and operation time(P>0.05). In TRS group,16 patients' injury were closured directly,wound healing time of 16 patients were over 3 about weeks,VAS score was 3.9±1.1,VSS score was 3.5±1.2,and 1 patient occurred complication;In self-made skin stretch group,12 patients' injury were closured directly,wound healing time of 9 patients were over 3 about weeks,VAS score was 4.8±1.4,VSS score was 5.3±1.6,and 9 patients occurred complication;there were no statistical differences between two groups in these items.
Conclusion: Compared with self-made skin stretch,TRS has advantages of good effect of wound,minimal trauma,short healing time,less pain,good outlook,and less complication. |
| KEY WORDS Soft tissue injuries Skin Stretch receptors Case-control studies |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡炜,邵银初,李浩,单记春,杨红,双峰.不同皮肤牵张闭合器治疗皮肤软组织缺损的临床研究[J].中国骨伤,2019,32(11):1021~1025 |
| 英文格式: | HU Wei,SHAO Yin-chu,LI Hao,SHAN Ji-chun,YANG Hong,SHUANG Feng.Different skin-stretching devices for the treatment of skin and soft tissue defects[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(11):1021~1025 |
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