探讨反鼓式皮片移植联合负压封闭引流(VSD)技术修复大面积皮肤撕脱伤的可行性及临床效果。

回顾性分析安阳市人民医院烧伤整形科在2017年2月至2020年8月收治的不同原因所致的大面积皮肤撕脱伤病例40例，按照手术方式不同分成试验组和对照组，每组各20例。试验组患者应用反鼓式皮片移植联合VSD技术修复创面；对照组患者应用反鼓式取皮回植术修复创面；比较2组患者术后10 d皮片成活率、手术次数、住院费用、住院时间以及术后并发症发生情况与术后6个月瘢痕增生情况。对数据行t检验和χ²检验。

试验组皮片成活率[(85.9±1.3)%]较对照组[(77.5±3.5)%]明显升高，差异有统计学意义(t ＝8.40，P＝0.01)；试验组患者手术次数[(1.9±0.9)次]、住院费用[(2.7 ± 0.8)万元]、住院时间[(25.6 ± 8.0) d]，与对照组[(2.5±1.5)次、(3.9 ± 1.0)万元、(41.6 ± 12.5) d]相比，差异均有统计学意义(t＝3.31、1.38、4.18，P< 0.05)；试验组术后4例发生并发症，对照组术后9例发生并发症，比较差异无统计学意义(χ²＝1.9, P＝0.168)；术后6个月，试验组患者瘢痕增生情况整体轻于对照组，差异有统计学意义(χ²＝9.17, P＝0.01)。

反鼓式皮片移植联合VSD在修复皮肤撕脱伤方面具有较好的临床效果，瘢痕轻，修复时间短，值得临床上推广。

To investigate the feasibility and clinical effect of anti-drum skin grafting combined with vacuum sealing drainage (VSD) in repairing large area skin avulsion injury.

From February 2017 to August 2020, 40 patients with large area skin avulsion injury were treated in the Department of Burns and Plastic Surgery, Anyang People′s Hospital. The patients were divided into the experimental group and the control group according to the surgical method, 20 patients in each group. The patients of study group were treated with anti-drum skin grafting combined with VSD. The patients in the control group were treated with anti-drum skin grafting and reinplantation to repair the wound. The survival rate of skin grafts 10 days after the operation the number of operations, the cost of hospitalization and the length of hospitalization were compared between the 2 groups. As well as the incidence of postoperative complications and scar hyperplasia 6 months after the operation. Data was processed with t test and χ² test.

The survival rate of skin grafts in experimental group [(85.9±1.3)%] was significantly higher than that in control group [(77.5±3.5) %], and the difference was statistically significant (t=8.40, P=0.01). The number of operations, the cost of hospitalization and length of hospitalization of the experimental group were [(1.9±0.9) times, (2.7±0.8) ten thousand yuan, (25.6±8.0) d], and the control group were [(2.5±1.5) times, (3.9±1.0) ten thousand yuan, (41.6 ± 12.5) d], there were statistically significant differences between the two groups(t=3.31, 1.38, 4.18; P<0.05). Four patients occurred postoperative complications in experimental group, while 9 patients occurred in control group, and there was no significant difference between two groups(χ²=1.91, P=0.168). The postoperative scar hyperplasia 6 months after the operation in experimental group was lighter than that in control group, the difference was statistically significant(χ²=9.17, P=0.01).

Anti-drum skin grafting combined with VSD has good clinical effect in repairing large area skin avulsion injury, with light scar and short repair time, which is worthy of clinical promotion.