肌肉锚定联合负压植皮修复股前外游离皮瓣供区继发创面-国际临床研究杂志-CSCIED科技核心评价数据库-手机版

肌肉锚定联合负压植皮修复股前外游离皮瓣供区继发创面

Muscle anchoring unite negative pressure and skin grafting in repairing secondary wounds in doner sites of free anterolateral femoral perforator pfaps

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DOI	10.12208/j.ijcr.20230116
刊名	国际临床研究杂志 International Journal of Clinical Research
年，卷(期)	2023, 7(3)
作者	庞远翔,杨力*,薛君荣,蒋鹏,陈伟培,周文昌,郭贤钊,
作者单位	广西玉林市第一人民医院烧伤整形外科广西玉林 ;
摘要	探讨肌肉锚定联合负压植皮修复股前外游离皮瓣供区继发创面临床效果。方法选取笔者单位2020年1月-2021年1月 9例切除股前外侧游离皮瓣后供区无法直接拉拢缝合关闭创面患者，均为男性，皮瓣切取面积为14cm×9cm-24cm×18cm，皮瓣切取后供区无法直接拉拢缝合，将外露肌肉修整，以2-0吸收线内翻缝合形成平整创面，4-0可吸收线将皮缘真皮浅层、阔筋膜残端、肌肉锚着固定，让供区形成平整相对稳定创面，取刃厚皮移植其上，负压覆盖固定加压。结果术后8例皮片全部一期存活未出现坏死，1例患者为硬皮病患者，皮片质量较差，术后皮片部分坏死，进行了二期植皮修复。术后2月随访，所有患者植皮区瘢痕平坦，行走无明显肌肉疝出，取瓣区肢体无功能障碍。结论肌肉锚定联合负压植皮能够较传统供区植皮加压包扎方法更利于创面一期修复，供区愈合较平整，是修复股前外供区继发创面一个良好方法。
Abstract	Objective To investigate the clinical effect of muscle anchoring unite negative pressure and skin grafting in repairing secondary wounds in doner sites of free anterolateral femoral perforator pfaps. Methods From January 2020 to January 2021, 9 patients (all males, aged 16-68 years) were treated by free anterolateral femoral perforator flaps and the donor site could not be directly.Flap sizes ranged from 14cm×9cm-24cm×18cm,The donor site could not be directly due to various factors,First, the exteriorized muscle was trimmed . Then use varus sutures with 2-0 SB-ORB to make the wound flat，Anchoring the superficial dermis of wound margin and muscle by 4-0 SB-ORB, make the donor area form a flat and relatively stable wound . Last , thick skin grafts on the wound surface ,negative pressure material is covered, fixed and pressurized. Results After operation, 8 cases of skin graft survived and no necrosis , 1 casewas scleroderma ,the quality of skin graft was poor, and the skin graft was partly necrotic after operation，need to skin grafting secondary. All patients were followed up for 2 months after operation, the scar of skin graft area was flat, and no obvious muscle hernia during walking and dysfunction of the limbs. Conclusions Muscle anchoring unite negative pressure and skin grafting can overcome some shortcomings of traditional skin grafting , more favorable for wound one-stage repair and donor site is flatter . Suitable for repairing secondary wounds in doner sites of free anterolateral femoral perforator pfaps.
关键词	游离股前外侧穿支皮瓣；供区；皮片移植；负压治疗
KeyWord	Free anterolateral femoral perforator pfaps; Doner sites; Skin graft; Negative pressure therapy
基金项目
页码	45-49

参考文献
相关文献

[1] 刘元波, 唐茂林. 穿支皮瓣的历史、演变和给予我们的启示
[J]. 中华整形外科杂志, 2018, 34(009):681-687.

[2] Jeng SF, Tan NC. Optimizing aesthetic and functional outcomes at donor sites.
[J]. Chang Gung Med J, 2012, 35(03):219-230.

[3] Lin CH ,FC Wei, Lin YT , etal. Lateral circumflex femoral artery system: warehouse for functional composite free-tissue reconstruction of the lower leg.
[J]. Journal of Trauma, 2006, 60(5):1032-6.

[4] 周晓, 薛明宇, 芮永军,等. 以膝上外侧穿支为蒂的V-Y皮瓣修复股前外侧皮瓣供区
[J]. 中华整形外科杂志, 2014, 30(001):26-29.

[5] 高秋芳, 张小锋, 张万锋,等. 股内侧肌穿支皮瓣修复游离股前外侧穿支皮瓣供区继发创面的临床效果
[J]. 中华烧伤杂志, 2019, 35(1):65-68.

[6] 施权, 王波, 魏在荣,等. 旋髂浅动脉穿支皮瓣修复股前外侧穿支皮瓣供区创面的可行性及效果
[J]. 中华烧伤杂志, 2017, 33(005):309-311.

[7] 滕云升, 梁高峰, 文波,等. 股前穿支接力皮瓣修复游离股前外侧皮瓣供区创面
[J]. 中华显微外科杂志, 2017, 40(2):126-129.

[8] 刘胜哲, 巨积辉, 柳志锦,等. 串并联双股前外侧超长穿支皮瓣修复四肢大面积创面的临床效果
[J]. 中华烧伤杂志 2021年37卷3期, 1-7页, MEDLINE ISTIC PKU CSCD, 2021.

[9] 毛炳焱, 刘平均, 贺用礼,等. VSD结合拉网式中厚皮肤移植修复足背皮肤软组织缺损
[J]. 中华全科医学, 2011, 09(010):1530-1530.

[10] 孔靖, 钟格兰. 大面积皮肤缺损游离植皮中传统打包技术与负压封闭引流的应用比较
[J]. 临床和实验医学杂志, 2015, 000(018):1548-1551.

[11] 谢爱国, 李磊, 蔡薇,等. 负压封闭引流技术在游离植皮区的临床应用
[J]. 医学研究生学报, 2010, 23(4): 444-446.

[12] Jaffe L,Wu SC.Dressings, Topical Therapy,and Negative Pressure Wound Therapy
[J]. Clinics in Podiatric Medicine and Surgery, 2019, 36(3).

[13] Strugala V, Martin R . Meta-Analysis of Comparative Trials Evaluating a Prophylactic Single-Use Negative Pressure Wound Therapy System for the Prevention of Surgical Site Complications
[J]. Surgical Infections, 2017, 18(7):810-819.

[14] Costa, Matthew, L. Negative Pressure Wound Therapy for Open Fractures Reply
[J]. Jama the Journal of the American Medical Association, 2018.

[15] Sogorski A , Lehnhardt M , Goertz O, etal.Improvement of local microcirculation through intermittent Negative Pressure Wound Therapy (NPWT)
[J]. Journal of Tissue Viability, 2018:S0965206X18300287.

[16] Valerio, Cozza, Marco, etal. Empirical measurement of pressure in NPWT for infected wounds: how long can it really stay under pressure
[J]. Wound Repair & Regeneration Official Publication of the Wound Healing Society the European Tissue Repair Society, 2018.

[17] 崔文波, 魏小华.负压封闭引流与常规敷料加压包扎对游离皮片植皮疗效的对比
[J].临床医学,2012,32(012): 13-15.

[18] 王伟,潘朝晖,薛山等.负压封闭引流与传统加压包扎法在治疗前臂皮肤脱套伤中的临床效果
[J]. 临床与病理杂志, 2017(9).

引用本文

庞远翔,杨力*,薛君荣,蒋鹏,陈伟培,周文昌,郭贤钊. 肌肉锚定联合负压植皮修复股前外游离皮瓣供区继发创面 [J]. 国际临床研究杂志. 2023; 7; (3). 45 - 49.

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