皮肤牵张器与负压伤口治疗技术单独和联合使用对大面积皮肤缺损创面的疗效研究

摘要

目的 研究皮肤牵张器与负压伤口治疗技术单独和联合使用对大面积皮肤缺损创面的临床治疗效果.方法 选择2012年2月-2016年12月在我院进行诊治的大面积皮肤缺损患者60例,根据治疗方法的不同分为3组,单独行负压伤口治疗者为A组,单独行皮肤牵张器治疗者为B组,行皮肤牵张器与负压伤口治疗技术联合治疗者为C组,每组各20例.分别比较3组患者治疗前、治疗第1、3、7天创面面积、血管内皮生长因子水平、创面引流液透明质酸水平以及分泌物细菌计数的变化.结果 随着治疗时间的增加,3组患者的创面面积均呈逐渐缩小的趋势.治疗第1、3、7天,B组的创面面积明显小于A组(P＜0.05),且C组的创面面积明显小于A组和B组(P＜0.05);随着治疗时间的增加,3组患者的创面分泌物细菌计数均呈逐渐缩小的趋势.治疗第1、3、7天,A组的创面分泌物细菌计数明显低于B组(P＜0.05),且C组的创面分泌物细菌计数明显低于A组和B组(P＜0.05);随着治疗时间的增加,3组患者的血管内皮生长因子和透明质酸水平均呈逐渐升高的趋势.治疗第1、3、7天,C组的血管内皮生长因子和透明质酸水平均明显低于A组和B组(P＜0.05).结论 皮肤牵张器与负压伤口治疗技术联合使用促进大面积皮肤缺损患者创面愈合的临床效果明显优于二者单独使用,具有较高的临床应用价值.%Objective In order to investigate the clinical effect of skin traction and negative pressure wound treatment on large area skin defect.Methods Selected 60 cases of patients with large area skin defect who were treated in our hospital from February 2012 to December 2016,divided into three groups.The single arm negative pressure wound treatment for group A,single skin traction device for group B,the skin traction and negative pressure wound treatment for group C.The changes of wound area,vascular endothelial growth factor,the level of hyaluronic acid in wound drainage fluid and the count of bacteria in secretions were compared between the three groups before and after treatment at the first,third and seventh day,respectively.Results With the increasing of the treatment time,the wound area of the three groups showed a gradually decreasing trend.The wound area of the group B at the first,third and seventh day and was significantly smaller than that of group A (P＜0.05),and the wound area of group C was significantly smaller than that of group A and group B (P＜0.05);the bacterial count of wound secretion at the first,third and seventh day in group A was significantly lower than that in group B (P＜0.05),and the bacterial count of wound secretions in group C was significantly lower than that in group A and group B (P＜0.05).With the increasing of treatment time,the levels of VEGF and HA in the three groups showed a trend of gradually increasing.The levels of VEGF and HA at the first,third and seventh day in group C were significantly lower than those in group A and group B (P＜0.05).Conclusion The clinical effect of skin traction device combined with negative pressure wound therapy in promoting the healing of large area skin defect is obviously better than that of the two alone,and it has higher clinical value.