马双飞聂顺义

胫腓骨骨折皮肤软组织缺损给予皮片移植修复并负压封闭引流的临床研究

马双飞1，2聂顺义1，2

目的 研究胫腓骨骨折皮肤软组织缺损给予皮片移植修复并负压封闭引流的临床效果。方法 抽选42例胫腓骨骨折皮肤软组织缺损患者为研究组，给予皮片移植修复并负压封闭引流治疗，另选取42例为对照组，未接受负压封闭引流，以临床疗效、不良反应为标准评析治疗效果。结果 对照组的临床总好转率为69.0%，比较之下研究组的90.5%显著更高（P＜0.05）；两组均未见明显严重不良反应。结论 胫腓骨骨折皮肤软组织缺损给予皮片移植修复并负压封闭引流可彻底清除创面的坏死组织与分泌物，改善局部微循环并消除感染，临床应用价值较高。

胫腓骨骨折；软组织缺损；皮片移植修复；负压封闭引流

【Abstract】

Objective To study the clinical effect of tibia and fibula fracture with skin and soft tissue defect treated with skin graft repair and vacuum sealing drainage. Methods 42 cases of tibia and fibula fracture patients with skin and soft tissue defect as the study group， they were given the skin graft repair and vacuum sealing drainage in the treatment， another 42 cases were selected as the control group， they were not given vacuum sealing drainage， clinical efficacy， adverse reactions as the standard analysis of therapeutic effects. Results The total improvement rate in the control group was 69.0%， the total improvement rate in the study group（90.5%） was significantly higher（P＜0.05）. There were no serious adverse reactions in the two groups. Conclusion Tibia and fibula fracture skin and soft tissue defect give skin graft for repairing and vacuum sealing drainage can completely remove wound necrotic tissue and secretion， improve local microcirculation， and eliminate the infection， clinical application value is higher.

【Key words】Tibia and fibula fracture， Soft tissue defect， Skin graft repair， Vacuum sealing drainage

胫腓骨骨折皮肤软组织缺损在当前骨科临床十分常见，其对骨折愈合很不利。以往临床多采取简单的外固定，并对创面进行清创换药，待感染控制、肉芽生长旺盛之后植皮或皮瓣转移，但这种治疗手段不仅费用高、延长病程，徒添患者的痛苦，同时还可能导致感染扩散，致使周围组织进一步坏死，甚至要靠截肢才能彻底根治［1-2］。负压封闭引流是一种通过全创面接触进行引流的治疗方式，能有效清除创面的坏死组织与渗出液，改善周围组织的血液循环，从而达到促进受损组织愈合的功效［3］。本次研究拟针对胫腓骨骨折皮肤软组织缺损采取皮片移植修复并负压封闭引流，成效确切。……