临床小儿外科杂志2024，Vol.23Issue(11)：1062-1067,6.DOI:10.3760/cma.j.cn101785-202405030-011
负压创面修复技术联合皮肤移植治疗小儿大面积皮肤撕脱伤的疗效观察
Efficacy observation of negative pressure wound therapy combined with skin grafting for the treatment of large-scale skin avulsions in children
摘要
Abstract
Objective To explore the efficacy and surgical experience of combining negative pressure wound therapy(NPWT)with skin grafting in the treatment of large-scale skin avulsions in children.Methods A retrospective analysis was conducted on the clinical data of 40 children with large-scale skin avulsions who were treated at the Medical Center of Bum Plastic Surgery and Wound Repair of the First Affiliated Hospital of Nanchang University from June 2018 to June 2023.All patients underwent thorough debridement in the emer-gency operating room,with split-thickness skin grafting and NPWT applied.Outcomes observed included skin graft survival at 14 days post-surgery,granulation growth time,NPWT treatment duration,wound healing time,and hospital stay.Follow-up assessments at 8 months included skin color,elasticity subcutaneous fullness,scar proliferation,and joint function.Levels of inflammatory factors and bacterial detection rates in the grafted areas were also measured.Results Among the 40 children,29 had complete skin graft survival(29/40,72.50％),and 25 had surviving grafts with blood supply(25/40,62.50％).The overall skin graft survival rate was(85.18±2.18)％,with granulation growth time of(8.55±1.18)days,wound healing time of(21.55±6.37)days,NPWT treatment duration of(19.55±6.02)days,and hospital stay of(36.25±3.18)days.There was no statistically significant difference in the overall bacterial detection rate during NPWT compared to before treatment(P＞0.05).No severe complications were reported;2 cases had initial wound infections,and 1 case had mild pressure sores during hospitalization.Follow-up duration exceeded 8 months,with skin color scores of(2.63±0.63)and skin texture scores of(2.85±0.36).Levels of Interleukin-6(IL-6),Interleukin-23(IL-23),and tumor necrosis factor-α(TNF-α)decreased significantly after treatment compared to before,with values of(102.26±12.21 vs.58.93±7.44),(182.54±13.52 vs.110.74±10.25),and(6.92±0.47 vs.4.57±0.52),respectively(P＜0.05).Conclusions The combination of NPWT and skin grafting is ef-fective in promoting granulation tissue repair,achieving high graft survival rates,reducing infection rates,and improving graft adherence.It shows good clinical application value for treating large-scale skin avulsions in chil-dren.关键词
儿童/皮肤撕脱/负压创面修复技术/皮肤移植/疗效Key words
Child/Skin Avulsion/Negative Pressure Wound Therapy/Skin Grafting/Efficacy引用本文复制引用
廖新成,江政英,付忠华,刘名倬,郭光华..负压创面修复技术联合皮肤移植治疗小儿大面积皮肤撕脱伤的疗效观察[J].临床小儿外科杂志,2024,23(11):1062-1067,6.基金项目
国家自然基金地区科学基金项目(82160380) （82160380）
江西省中医药管理局科技计划(2023B0821) National Natural Science Foundation Regional Science Fund(82160380) （2023B0821）
Science and Technology Plan of Jiangxi Provincial Administration of Traditional Chinese Medicine(2023B0821) （2023B0821）
