恶性皮肤肿瘤切除术后伤口缺损的游离移植整形手术:一项试点研究。

S I Korovin, S A Dedkov, V V Ostafiichuk, M M Kukushkina
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摘要

目的:评估恶性皮肤肿瘤患者用游离植皮关闭缺损后应用负压绷带(VAC绷带)的效果,并与用普通软膏绷带固定植皮进行比较。材料与方法:研究纳入了2019年至2023年在国家癌症研究所接受手术治疗的61例恶性皮肤肿瘤患者。所有患者的伤口缺损闭合均采用劈开植皮术。手术时,41 名患者在使用分层植皮关闭伤口缺损后,使用负压敷料(VAC 绷带)7 天(第 1 组)。20 名患者在手术后使用普通软膏加压绷带固定移植的皮肤(第 2 组)。术后一周对即时效果进行评估:结果:第 1 组 53.7 ± 7.8% 的患者皮瓣完全移植,第 2 组 5.0 ± 4.8% 的患者皮瓣完全移植(P = 0.002)。第一组有 1 例移植物完全坏死,第二组有 2 例(P = 0.496):结论:就完全移植的数量而言,VAC-绷带组的术后伤口移植效果明显优于传统的加压软膏绷带组。
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PLASTIC SURGERY OF WOUND DEFECTS WITH FREE GRAFTS AFTER MALIGNANT SKIN TUMORS EXCISION: A PILOT STUDY.

Aim: To evaluate the effectiveness of applying negative pressure bandages (VAC bandage) in patients with malignant skin tumors after closing defects with free skin grafts and to compare it with fixation of skin grafts by the ordinary ointment bandages.

Materials and methods: 61 patients with malignant skin tumors who underwent surgical treatment at the National Cancer Institute from 2019 to 2023 were included in the study. For the wound defects closure, the split skin grafts were applied in all patients. At the time of surgery, after closing a wound defect by a split skin graft, a negative pressure dressing (VAC bandage) was applied in 41 patients for 7 days (group 1). In 20 patients, a transplanted skin graft was fixed after surgery by an ordinary ointment pressure bandage (group 2). The immediate results were evaluated one week after surgery.

Results: Complete engraftment of the flap in group 1 was observed in 53.7 ± 7.8% cases, in group 2 this result was achieved in 5.0 ± 4.8% patients (p = 0.002). The complete graft necrosis occurred in 1 case in group 1 vs. 2 cases in group 2 (p = 0.496).

Conclusion: The results of the engraftment in postoperative wounds were significantly better in the VAC-bandage group in terms of the number of the complete engraftments compared to the conventional pressure ointment bandage group.

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