负压封闭引流联合皮肤牵张技术在跟腱断裂修补术后创面软组织缺损修复中的应用

doi:10.3760/cma.j.cn101202-20200509-00157

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摘要目的探讨负压封闭引流(VSD)联合皮肤牵张技术修复跟腱断裂修补术后创面软组织缺损的临床疗效。方法回顾性研究。纳入2016年1月—2017年11月安徽省界首市人民医院收治的跟腱断裂修补术后创面软组织缺损患者13例,其中男5例,女8例;年龄28～65(43.69±12.05)岁。创面软组织缺损面积3 cm×2 cm～5 cm×6 cm。患者一期行清创+VSD术,待创面感染控制、肉芽生长良好后,二期应用皮肤牵张器闭合创面。术后定期随访,比较术前及末次随访患者踝关节疼痛VAS评分和踝关节功能Kofoed评分;依据Kofoed评分标准评定疗效。结果 13例患者创面经一期清创+VSD手术治疗后,新鲜肉芽组织生长良好,感染控制佳;二期采用皮肤牵张技术闭合创面,均一期愈合。患者均获随访,随访时间3～6(4.77±1.09)个月,切口创面均愈合良好,外观线性瘢痕形成,局部少许色素沉着,皮肤弹性正常,踝关节活动自如,无迟发型跟腱断裂发生。末次随访患侧踝关节疼痛VAS评分(1.08±0.64)分,低于术前的(4.23±0.83)分;踝关节功能Kofoed评分(86.23±6.60)分,高于术前的(65.08±5.66)分;差异均有统计学意义(t=30.778、9.365,P值均＜0.05);按照踝关节功能Kofoed评分标准评定疗效,优8例、良4例、可1例。结论 VSD联合皮肤牵张技术修复跟腱断裂修补术后创面软组织缺损,简便方便,安全有效,同时愈合瘢痕小,避免皮瓣修复创面所带来的损伤。

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关键词 ：跟腱, 创面软组织缺损, 负压封闭引流, 皮肤牵张术

Key words： Achilles tendon Wound soft tissue defect Vacuum sealing drainage Skin stretch operation

收稿日期: 2020-05-09

通讯作者: 周晓东,Email:ahjshyyzhxd@163.com

引用本文:

周晓东, 张维龙, 陈子龙, 陈俊宇. 负压封闭引流联合皮肤牵张技术在跟腱断裂修补术后创面软组织缺损修复中的应用[J]. 中华解剖与临床杂志, 2020, 25(4): 429-432.
Zhou Xiaodong, Zhang Weilong, Chen Zilong, Chen Junyu. Application of vacuum sealing drainage combined with skin stretch operation technique for repairing achilles tendon postoperative wound soft tissue defects. Chinese Journal of Anatomy and Clinics, 2020, 25(4): 429-432.

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