急性头皮减张联合负压引流在感染性头皮缺损中临床应用.docVIP

急性头皮减张联合负压引流在感染性头皮缺损中临床应用 　　【摘 要】 目的 探讨头皮急性减张及负压引流术在治疗头部组织缺损并头皮感染中的临床应用。方法 2009年9月～2015年9月，应用头皮急性减张缝合联合负压引流修复头部组织缺损并头皮感染11例，男，6例，女5例； 年龄12～56岁，平均38岁，病程1h～2m，创面大小为3.0cm×6cm～4cm×10cm。缺损宽度均在4cm内，手术次数1-3次，疗程3W-8W。 结果 所有患者头皮感染均得到有效控制，颅骨外露均减张缝合皮瓣修复，无继发感染，术后8例获随访，随访时间6～24月，平均12月。 无明显瘢痕性秃发，见浅表瘢痕形成。结论 皮肤的急性减张缝合适用于宽度小于4cm以下狭长型皮肤缺损，联合负压引流可以有效控制头皮帽状腱膜及骨膜层的感染同时有利于创面愈合。该手术操作简便，能早期修复创面，避免颅骨长期外露。 　　【关键词】 减张皮瓣 组织缺损 负压引流 感染 颅骨外露 　　The clinical application of the acute relaxation suture and vacuum sealing drainage in the treatment of infective soft tissue defect in the head 　　Liu Jixin，Tang Xiujun， Wang Dali， Wei Zairong，Wang Bo. Department of Burn and Plastic Surgery， Affiliated Hospital of Zunyi Medical College， Zunyi 563003， China. 　　【Abstract】 Objective To investigate the clinical application of the acute relaxation suture and vacuum sealing drainage in the treatment of soft tissue defect in the head with scalp infection. Method Between September 2009 and September 2015， 11 cases of defect in head and scalp infection ，repaired by acute relaxation suture combined with vacuum sealing drainage， male in 6 cases and female in 5 cases；12 ～ 56 years， average age 38， disease course were 1 h ～ 2 m， wound size were 3.0 cm * 6 cm to 4 cm * 10 cm. Within 4 cm in width. And had 1-3 times operation. The treatment course was 3-8weeks. Results All patients with scalp infection controlled effectively， skull exposure were repaired with flaps plus relaxation suture， without secondary infection， 8 cases of postoperative follow-up， follow-up time is 6 ～ 24 months， an average of 12 months .No distinct cicatricial alopecia， but had formated superficial scar. Conclusion Acute relaxation suture applies to long and narrow skin defect which its width less than 4 cm， combined with vacuum sealing drainage can effectively control the galea aponeurosis and periost infection and promote wound healing at the same time. The operation is simple，can repair the wound early， avoid skull exposure for a long time.