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双语推荐：四肢毁损伤皮肤缺损

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目的：探讨负压封闭引流（VSD技术在四肢毁损伤皮肤缺损创面中的治疗效果。方法对2011年12月-2013年12月我科收治的四肢毁损伤皮肤缺损患者51例进行分析。30例行清创后负压封闭引流（VSD），经过14-21 d负压封闭引流（VSD）达到二期植皮准备。5例经过7-10 d负压封闭引流（VSD）达到二期植皮创面准备，13例经过21 d负压封闭引流（VSD）后，经过3 d浸泡换药后达到二期植皮创面准备。3例经过20-28d传统换药达到二期植皮创面准备。结果负压封闭引流（VSD）组在治愈率、总有效率和创面达到二期植皮创面及保存肢体长度上有统计学意义。结论负压封闭引流是四肢毁损伤皮肤缺损的理想方法之一，值得推广应用。
Objective To investigate the effect of vacuum sealing drainage (VSD) technology in the treatment of extremities de-structive injury dermal wounds patients. Methods The present study enrolled 13 limb injury ruined skin defects patients from 2010.3 to 2013.12. 30 patients accepted VSD treatment after debridement, 14~21 days later, patients were ready for secondary skin transplantation. 5 patients were prepared to secondary skin transplantation ater 7~10 days of VSD treatment, 13 patient reached secondary skin transplantation preparation after 21 days of VSD treatment and wounds were soaked in saline ,3 patients got ready for secondary skin transplantation after 20~28 days changing dressing. Results VSD is an ideal method for limb injury ruined skin defects patients, which is worth popularizing.Conclusion Vacuum sealing drainage is destroyed one of the ideal method of limbs injury with skin defect, it is worthy of popularization and application.

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目的探讨急诊使用外固定架联合负压封闭引流术(vacuum sealing drainage,VSD)治疗合并严重软组织损伤的四肢开放性骨折的临床效果。方法对38例有严重软组织损伤的四肢开放性骨折患者急诊采用外固定架辅以有限内固定固定骨折,并早期联合VSD。其中11例面积较大皮肤软组织撕脱创面I期打薄皮肤回植,20例软组织缺损创面无法I期修复,经VSD后创面缺损由新生肉芽组织填充,行皮瓣或自体中厚皮片移植术修复;7例软组织严重污染并高度肿胀,经2次清创术并联合使用VSD,行直接拉拢缝合或自体中厚皮片移植术修复创面。结论 11例I期回植的皮肤绝大部分存活;20例合并软组织缺损创面未发生感染,7例软组织严重污染并高度肿胀患者患肢肿胀消退,未发生骨筋膜室综合症,Ⅱ期修复均成活。随访15-24个月,所有病例骨折愈合,无骨髓炎、骨不连发生,外固定架及内固定均拆除。结论外固定架联合VSD急诊处理合并严重软组织损伤的四肢开放性骨折疗效良好。
@@@@Objective To investigate the clinical effect of external fixation combined with vacuum sealing drainage(vacuum sealing drainage,VSD) in emergency treatment of open fractures of extremities with severe soft tissue injury. Methods Totally 38 cases open limb fractures with serious soft tissue injury were treated with external fixator supplemented with limited internal fixation and combined with VSD in emergency. 11 cases with large area skin avulsion were treated by skin grafting. Totally 24 cases of soft tissue defect cannot be repaired in one-stage. Skin defects were filled by granulation tissue after the application of VSD and repaired by flaps and free skin graft. Totally 7 cases of Soft tissue serious pollution and high swelling, after two times debridement and application of VSD,were repaired by suture or autologous split-thickness skin graft. Results 11 cases of skin grafting were almost healed. 20 cases of soft tissue defect were not infected.7 cases of Soft tissue serious pol

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探讨游离股前外侧穿支皮瓣修复四肢皮肤软组织缺损创面的方法和临床效果。方法:2010年6月~2013年12月收治创伤后肢体皮肤软组织缺损患者19例,其中男15例,女4例;年龄13~55岁,平均33岁;伤后至入院时间为1 h~55 d;损伤部位:小腿9例,足部5例,前臂2例,手部3例;缺损范围3 cm×8 cm~13 cm×25 cm,均采用游离股前外侧穿支皮瓣修复创面。记录手术时间、手术出血量、输血量、术后并发症发生率、皮瓣稳定时间、二次手术整形率、患者满意度,随访6~24个月。结果:纳入病例19例,平均手术时间(239±35)min;平均术中出血量(236±45)m L,平均输浓缩红细胞(0.74±0.3)U;术后并发症发生率9%,皮瓣稳定时间(6.4±1.2)d;术后需二次手术整形修整皮瓣1例,修整率5.1%。术后8个月11例获保护性感觉,患者满意率95%。结论:游离股前外侧穿支皮瓣是修复四肢皮肤软组织缺损的理想方法。
Objective:To explore the therapeutic effect of anterolateral thigh perforator free flaps for reconstruction of four limb soft tissue defects. Methods:Among 19 patients were treated with anteriolateral thigh perforator free flap for traumat-ic soft tissue defects from June 2010 to December 2013,15 cases were male,female 4 cases;the age of the 19 patients was ranging from 13 to 55 years old,and the average age was 33. The time between the injury and the operation was 1 h~55 d. The damaged part:9 cases in leg,5 cases in foot,2cases in forearm and 3 cases in hand. The sizes of those soft tissue defects were from 3 cm × 8 cm to 13 cm × 35 cm. Operation time,blood loss,blood transfusion,postoperative complications,flap stabilization time,second plastic surgery rates and patient satisfaction were recorded. All the patient were followed up for 6 to 24 months. Results:All flaps survived completely,the mean operation time were( 239 ± 35 ) mins,the mean blood loss were(236 ± 45)mL,t

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目的：探讨负压封闭引流（ VSD）技术应用于软组织损伤创面早期修复的疗效；方法：对68例四肢软组织损伤患者将撕脱、离体及弃用肢体皮肤修剪成网状全厚皮片或含真皮下血管网皮瓣回植覆盖皮肤缺损创面，采用负压封闭引流技术促进创面肉芽组织及皮片生长修复创面。结果：68例愈合时间15~28 d，术后创面Ⅰ期愈合率为82.4%，Ⅱ期愈合率为100%；经3~24个月随访，患者皮肤弹性、感觉恢复满意。结论：该技术有效促进创面肉芽组织及皮片生长，缩小Ⅱ期植皮或皮瓣转移修复创面，是一种操作简便、疗效确切的治疗方法。
Objective To investigate the effect of vacuun sealing drainage( VSD)technique was applied to the soft tissue injury of ear-ly wound repair. Method 68 patients with injury of soft tissue avulsion,isolated and abandoned the linb skin cut into a nesh of full thick-ness skin graft or flap with subdernal vascular network skin defect of planting back cover,VSD technology was applied to pronote granula-tion tissue growth and skin wound repair. Results 68 cases healed in 15 ~ 28 d,postoperative wound healing rate was 82. 4%,in stage II healing rate was 100%;after 3~24 nonths follow-up,patients with skin elasticity,sensory recovery satisfaction. Conclusion This tech-nique is effective to pronote the growth of granulation tissue and skin,can reduce secondary skin grafting or flap to repair the wound,is a sinple,effective nethod.

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目的 探讨利用旋股外侧动脉向皮瓣、筋膜或肌肉发出的穿支,形成以同一上级母体血管为蒂的不同的组织瓣,嵌合移植修复四肢创伤中的复杂组织缺损的可行性. 方法 从2010年1月至2012年3月,利用旋股外侧动脉向肌肉、筋膜及皮肤发出穿支,制成2～3个不同种类的组织瓣嵌合移植,对四肢环形组织缺损4例、多个创面3例、手足套状撕脱伤6例及GustiloⅢC型损伤9例进行修复.结果 22例中移植组织19例全部成活.有3例皮瓣远端出现约1.0～2.0 cm坏死；1例肢体远端坏死；无感染及骨髓炎发生.经6个月～2年的随访18例,皮瓣外形饱满,筋膜或肌肉植皮区皮肤有滑动、有弹性且无回缩,颜色无改变. 结论 旋股外侧动脉穿支嵌合皮瓣移植是修复四肢复杂创面较为实用有效的方法.
Objective To evaluate the feasibility and clinical efficacy of lateral femoral circumflex artery perforator flaps and fit together in the treatment of limbs complex wound surface.Methods From January 2010 to March 2012,use the characteristics that the descending branch of lateral femoral circumflex artery extend its branches over the flap,fascia and skin,to form lenticulostriate arteries,which contain 2 to 3 different species tissues fits together,flaps cover the important tissues such as vessel,nerves and bones.Fascia covers the tendinous tissues etc.Muscle can not only cover the tissues,but also fill in the space,and followed by skin grafting.This research was to perform the treatment for 4 cases of lacking limbs ring tissue,three cases of multiple wound surface,six cases of hand avulsion injury of skin and 9 cases of Gustilo grade-Ⅲ C.Results As for the 22 cases in the research,nineteen cases of flaps survived,the other 3 cases were necrosis with length of 1cm to 2 cm at distal and

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目的 探讨“T”形血管吻合的游离腓动脉穿支皮瓣移植修复四肢创面缺损的方法及临床效果.方法 自2009年3月至2012年5月,对9例四肢创面缺损的患者采用游离腓动脉皮瓣以“T”形血管吻合的方式移植修复,包括创伤导致皮肤、软组织缺损5例,合并有肢体主干血管损伤3例,糖尿病溃疡创面2例,足背肿物切除后感染导致皮肤坏死缺损1例,手背烧伤瘢痕1例.术后行显微外科常规治疗. 结果 2例术后发生静脉危象,经手术探查切除栓塞的静脉吻合口并予以重新吻合,9例皮瓣最终存活良好,皮瓣质地良好,外形美观,伤口均一期愈合,术后1个月经超声多普勒检查证实桥接血管血流均通畅(9/9,100％).7例获得有效随访12个月,患者对皮瓣外形满意度高(7/7,100％),术后6个月皮瓣恢复两点辨别觉,术后12个月平均值为(9.9 ±2.1)mm,皮瓣感觉评级为S3+级,AOFAS评分平均值为87.2,优3例,良4例. 结论 “T”形血管吻合的腓动脉穿支皮瓣移植可以较好的修复创面,同时能重建或避免破坏肢体远端血运,对于合并主干血管损伤的创面以及肢体远端血运不良导致的慢性缺血性创面的修复具有良好的适应证和应用价值.
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背景：软组织严重损伤的四肢开放性骨折的治疗比较棘手，其创面渗出多，换药次数多，感染率高，而怎样解决伤口处理与骨折固定之间的矛盾是临床治疗中需要考虑的问题。 目的：探讨外固定架+封闭负压引流在软组织严重损伤的四肢开放性骨折中应用的疗效。 方法：选择新乡医学院第一附属医院2009年12月至2010年12月收治的34例软组织严重损伤的四肢开放性骨折患者，其中男20例，女14例；平均年龄36.6岁；上肢骨折10例，下肢骨折24例；清创后形成皮肤缺损占体表面积1%-6%。在外固定架固定前提下，创面分别采用封闭负压引流(治疗组)和常规敷料包扎(对照组)各17例，根据肢体肿胀程度及肉芽生长情况，采用延期缝合、植皮或者皮瓣转移覆盖创面。治疗后观察创面感染率，肉芽生长情况等，并根据创面愈合及肉芽生长情况评估疗效。 结果与结论：治疗组11例治愈，5例显效，1例无效，总有效率约94%，感染率约15%；对照组治愈7例，显效6例，无效4例，总有效率约76%，感染率约40%，两组治愈率、总有效率、感染率比较差异有显著性意义(P<0.05)。治疗组创面愈合时间为8.66-16.23 d，对照组为15.68-22.36 d，治疗组创面愈合时间较对照组明显缩短(P <0.05)。可见封闭负压引流在软组织严重损
BACKGROUND:The treatment of limbs’ open fracture with severe soft tissue injury is very complicated. There are many wound exudates, high frequency of dressing change, and high infection rate. How to deal with the contradiction between wound treatment and fracture fixation is the considerable problem in clinical therapy. OBJECTIVE:To explore the effect of external fixator combined with vacuum sealing drainage on limbs’ open fracture with severe soft tissue injuries. METHODS:A total of 34 patients with limbs’ open fracture with severe soft tissue injuries were enrol ed in the First Affiliated Hospital, Xinxiang Medical Col ege from December 2009 to December 2010. There were 20 males and 14 females, with an average age of 36.6 years old. There were 10 cases of upper limb fracture and 24 cases of lower limb fracture. After debridement, cutaneous deficiency accounted for 1%to 6%of surface area. On the basis of external fixation, the wound received vacuum sealing drainage (treat

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