Vacuum sealing drainage based on wound surface dressing biomaterials for repairing soft tissue defects of the foot and ankle

doi:10.3969/j.issn.2095-4344.2014.16.024

Abstract

Abstract:

BACKGROUND: Preliminary studies have showed that vacuum sealing drainage based on wound surface dressing biomaterials is a good method to cover the wound as succedaneous peau when the soft tissuedefects along with open fracture cannot be completely repaired during the first operation.

OBJECTIVE: To explore the efficacy of vacuum sealing drainage based on wound surface dressing biomaterials in repair of soft tissue defects of foot and ankle.

METHODS: Fourteen patients with soft tissue defects of foot and ankle were treated using free skin graft combined with vacuum sealing drainage technique. Meanwhile, the traditional skin graft after wound dressing changes was applied in another 11 patients. The clinical outcomes were compared between two groups. RESULTS AND CONCLUSION: The transplanted skin in 10 cases of the vacuum sealing drainage group survived. The total survival rate was 71%, and surgical dressing change was applied in the left four patients to finally cover the wound. By comparison, the transplanted skin in four cases of the traditional group survived. The total survival rate was 54%. To finish the wound, three of the left patients were turned to surgical dressing change and two of them still needed skin graft operation once more. The total survival rate between the two groups has no statistical significance(P > 0.05). The therapeutic procedure noted that the time waiting for the secondary surgical visit, times for dressing change before the second intervention and the time for final union between the two groups were statistically different (P < 0.05). So the vacuum sealing drainage based on wound surface dressing biomaterials may accelerate the repair of soft tissue defects of foot and ankle when using the free skin graft operation.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: biocompatible materials, drainage, soft tissue injuries, skin transplantation

CLC Number:

R318

Yao Hui, Lu Hua-ding, Xu Yi-chun, Zhao Hui-qing, Lv Lu-lu. Vacuum sealing drainage based on wound surface dressing biomaterials for repairing soft tissue defects of the foot and ankle[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(16): 2607-2612.

Figures/Tables 2

2.1 参与者数量分析两组25例患者全部纳入结果分析。 2.2 两组患者基线资料对比两组患者在性别、年龄、致伤原因、合并症及缺损面积等方面基本一致，差异均无显著性意义(P > 0.05)，见表1。 2.3 两组临床效果对比试验组经过一期清创处理，一般经一二次更换负压装置，即可控制感染或使肉芽组织生长良好。只有1例意外擦伤患者，伤口未经正规治疗，慢性感染不愈合10个月余，创面进行性扩大，入院时缺损面积10 cm× 15 cm，经过3次更换负压装置，肉芽组织呈颗粒状生长良好，经过拉网植皮覆盖负压封闭引流装置，植皮完全成活。二期植皮术后1周打开负压装置，10例患者植皮完全成活，完全成活率为71%，另4例均通过换药而最终覆盖创面。对照组几乎需要每天更换创面敷料，有的甚至1 d需要更换2次，6例患者植皮完全成活，完全成活率为55%；剩余5例多出现部分皮片浮起或发黑坏死，3例通过换药愈合，有2例则进行了第2次植皮手术。两组患者的相关数据见表2，3。 2.4 典型病例病例1：76岁女性患者，不慎摔倒擦伤右小腿下段外侧，当时擦伤面积约0.5 cm×0.5 cm大小，未经正规处理，自行中药外敷，10个月来创面逐渐扩大。入院时创面缺损面积 10 cm×15 cm，表面被覆脓苔，考虑慢性感染性皮肤软组织缺损，经过清创高分子泡沫材料负压封闭引流技术联合游离植皮治疗，创面全部愈合(图1)。病例2：20岁男性患者，被货车撞倒后轧伤双足，左足内踝骨折无移位，软组织无明显异常。右足背及外踝处皮肤软组织撕脱，缺损面积5 cm×15 cm；入院经过清创换药植皮打包治疗，创面大部分愈合。残留少许皮片坏死区域经过换药最终愈合(图2)。 2.5 不良反应试验未发生与高分子材料相关的不良反应，以及其他不良反应。"

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