巫国庆 刘小飞 杨洋 陈然辰

    [摘要]目的：探討扩创植皮术联合负压封闭引流(Vacuum sealing drainage，VSD)对足部皮肤撕脱伤的修复效果及对组织液CD11b、细胞间黏附分子-1(ICAM-1)的影响。方法：回顾性分析2018年1月-2019年12月笔者医院接诊的100例足部皮肤撕脱伤患者临床资料，通过治疗方式不同分为观察组和对照组，每组50例。两组入院后均接受急诊清创处理，对照组使用扩创植皮术联合常规加压包扎法治疗，观察组使用扩创植皮术联合VSD治疗。比较两组围术期情况、植皮成活率、组织液中CD11b及ICAM-1水平、并发症发生率。结果：观察组手术时间、住院时间、创面愈合时间分别为(99.84±6.50)min、(12.45±2.61)d、(13.83±2.09)d，均明显短于对照组的(114.39±6.71)min、(18.16±2.18)d、(19.67±2.40)d;换药次数为(2.64±0.37)次，明显少于对照组的(3.21±0.58)次;换药时视觉模拟评分法(Visual analogue scale，VAS)评分为(3.06±0.48)分，明显低于对照组的(4.31±0.73)分，差异均有统计学意义(P0.05)。结论：扩创植皮术联合VSD治疗足部皮肤撕脱伤效果显著，可有效促进创面愈合及植皮存活，值得应用推广。

    [关键词]足部皮肤撕脱;扩创植皮术;负压封闭引流;加压包扎;感染;组织液

    [中图分类号]R622? ? [文献标志码]A? ? [文章编号]1008-6455(2021)07-0029-04

    Study on the Repair Effect of Augmented Skin Grafting Combined with VSD on Avulsion of Foot Skin

    WU Guo-qing，LIU Xiao-fei，YANG Yang，CHEN Ran-chen

    (Department of Burns and Plastic Surgery，909th Hospital of the Joint Logistics Support Unit of the Chinese People's Liberation Army，Zhangzhou 363000，Fujian，China)

    Abstract： Objective? To study the effect of expanded skin grafting combined with vacuum sealing drainage(VSD) in treatment of foot skin avulsion and the influence on tissue fluid CD11b and intercellular adhesion molecule-1 (ICAM-1). Methods? The clinical data of 100 cases with foot skin avulsion from January 2018 to December 2019 were analyzed retrospectively ......