Email Alerts
RSS
Volume 37 Issue 11
Nov.  2021
Turn off MathJax
Article Contents
Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2021  >  37(11): 1048-1053
Tong L,Hu XL,Zhang WF,et al.Clinical effects of bridge-type continuous negative pressure suction in postoperative fixation of upper limb soft tissue defect wound repaired with pedicled abdominal flap[J].Chin J Burns,2021,37(11):1048-1053.DOI: 10.3760/cma.j.cn501120-20210204-00050.
Citation: Tong L,Hu XL,Zhang WF,et al.Clinical effects of bridge-type continuous negative pressure suction in postoperative fixation of upper limb soft tissue defect wound repaired with pedicled abdominal flap[J].Chin J Burns,2021,37(11):1048-1053.DOI: 10.3760/cma.j.cn501120-20210204-00050.
shu

Clinical effects of bridge-type continuous negative pressure suction in postoperative fixation of upper limb soft tissue defect wound repaired with pedicled abdominal flap

doi: 10.3760/cma.j.cn501120-20210204-00050

  • Department of Burns and Cutaneous Surgery,Burn Center of PLA,the First Affiliated Hospital of Air Force Medical University, Xi'an 710032, China

Funds:

Natural Science Basic Research Project of Shaanxi Province of China 2020JM-322

More Information
  • Corresponding author: Guan Hao, Email: guanhao@hotmail.com
  • Received Date: 2021-02-04
    Abstract
  •   Objective  To observe the clinical effects of bridge-type continuous negative pressure suction in postoperative fixation of upper limb soft tissue defect wound repaired with pedicled abdominal flap.  Methods  The retrospective observational study was conducted. From April 2018 to October 2020, ninety-five patients who met the inclusion criteria were admitted to the First Affiliated Hospital of Air Force Medical University, including 55 males and 40 females, aged 5-78 years, with a defect wound area of 82 (9, 216) cm2. All patients underwent abdominal flap repair for soft tissue defects of hand and forearm. According to the different fixation methods adopted in the operation area, the patients were divided into negative pressure group (n=48) and plaster group (n=47). Wounds of the injury sites of patients in the 2 groups were repaired by flap transplantation after debridement. The negative pressure suction device was placed after dry gauze dressing to form a "bridge" to fix the affected upper limb and chest and abdomen in negative pressure group. Patients in plaster group were treated with conventional dry gauze matting and plaster fixation. On post surgery day (PSD) 1, 3, 5, 7, and 14, flap blood circulation and pain intensity of patients in the 2 groups were calculated by self-made blood flow scoring scale and Changhai Pain Ruler, respectively. On PSD 5, the common complications in operative area and surrounding skin were observed and their incidences were calculated. On PSD 7, satisfaction degree of patients was scored. During follow-up of one month after pedicle division, the appearance and functional recovery of the affected limb were observed. Data were statistically analyzed with analysis of variance for repeated measurement, independent samples t est, Cochran & Cox approximate t test, chi-square test, and Wilcoxon rank-sum test.  Results  On PSD 1, 3, 5, 7, and 14, the flap blood circulation scores of patients in negative pressure group did not change significantly, while that of patients in plaster group showed a time-dependent decrease, and the flap blood circulation scores of patients in negative pressure group were significantly higher than those in plaster group (t=2.259, 2.552, 2.784, 2.821, 3.003, P<0.05 or P<0.01). There were no significant changes in the pain intensity scores of patients in negative pressure group, while those of patients in plaster group increased in a time-dependent manner, and the pain intensity scores of patients in negative pressure group were significantly lower than those in plaster group (t=-4.818, -4.944, -5.011, -5.976, -6.721, P<0.05). On PSD 5, the incidences of common complications in operative area and surrounding skin of patients in negative pressure group were significantly lower than those in plaster group (χ2=6.773, 5.269, P<0.05 or P<0.01). On PSD 7, the satisfaction score of patients in negative pressure group was 14.7±1.1, which was significantly higher than 7.4±1.8 in plaster group (t=23.934, P<0.01). During follow-up of one month after pedicle division, the appearance and function of the affected limb of patients in the 2 groups recovered well.  Conclusions  After repairing the upper limb soft tissue defect wound with pedicled abdominal flap, the bridge-type continuous negative-pressure suction fixation can effectively immobilize the affected limbs, chest and abdomen, reduce the incidence of common complications in the operative area and surrounding skin, relieve the pain of immobilization of patients, improve the blood circulation of flap and patient's satisfaction. Thus, it is an effective, portable, comfortable, and easy-to-operate method.

     

    • FullText(HTML)
  • loading
    • References(31)
  • [1]
    ChawareSM,DhopteAA.The superficial inferior epigastric artery based abdominal flap for reconstruction of extensive defects of the hand and forearm: a modified design with primary closure of the donor site[J].Ann Plast Surg,2021,86(2):162-170.DOI: 10.1097/SAP.0000000000002669.
    [2]
    张子阳,唐修俊,魏在荣,等.腹部带蒂皮瓣修复上肢大面积皮肤缺损[J].中国修复重建外科杂志,2017,31(9):1102-1105.DOI: 10.7507/1002-1892.201703099.
    [3]
    刘长松,朱熙铭,徐强,等.穿支皮瓣与腹部带蒂皮瓣治疗手外伤皮肤软组织缺损疗效比较[J].中华全科医学,2020,18(10):1671-1674.DOI: 10.16766/j.cnki.issn.1674-4152.001589.
    [4]
    HorchRE,LudolphI,Müller-SeubertW,et al.Topical negative-pressure wound therapy: emerging devices and techniques[J].Expert Rev Med Devices,2020,17(2):139-148.DOI: 10.1080/17434440.2020.1714434.
    [5]
    PappalardoV,FrattiniF,ArditaV,et al.Negative pressure therapy (NPWT) for management of surgical wounds: effects on wound healing and analysis of devices evolution[J].Surg Technol Int,2019,34:56-67.
    [6]
    WebsterJ,LiuZ,NormanG,et al.Negative pressure wound therapy for surgical wounds healing by primary closure[J].Cochrane Database Syst Rev,2019,3(3):CD009261.DOI: 10.1002/14651858.CD009261.pub4.
    [7]
    KimPJ,AttingerCE,ConstantineT,et al.Negative pressure wound therapy with instillation: international consensus guidelines update[J].Int Wound J,2020,17(1):174-186.DOI: 10.1111/iwj.13254.
    [8]
    MuellerCK,BaderRD,EwaldC,et al.Scalp defect repair: a comparative analysis of different surgical techniques[J].Ann Plast Surg,2012,68(6):594-598.DOI: 10.1097/SAP.0b013e318218f32a.
    [9]
    李少珲,张万福,胡晓龙,等.负压伤口疗法在难固定部位中厚皮移植术中的临床应用[J].中华烧伤杂志,2020,36(7):528-533.DOI: 10.3760/cma.j.cn501120-20200224-00086.
    [10]
    Birke-SorensenH,MalmsjoM,RomeP,et al.Evidence-based recommendations for negative pressure wound therapy: treatment variables (pressure levels, wound filler and contact layer)--steps towards an international consensus[J].J Plast Reconstr Aesthet Surg,2011,64 (Suppl):S1-16.DOI: 10.1016/j.bjps.2011.06.001.
    [11]
    LeeKN,Ben-NakhiM,ParkEJ,et al.Cyclic negative pressure wound therapy: an alternative mode to intermittent system[J].Int Wound J,2015,12(6):686-692.DOI: 10.1111/iwj.12201.
    [12]
    ElhassanB,KarabekmezF,HsuCC,et al.Outcome of local anconeus flap transfer to cover soft tissue defects over the posterior aspect of the elbow[J].J Shoulder Elbow Surg,2011,20(5):807-812.DOI: 10.1016/j.jse.2011.02.010.
    [13]
    侯桥,岳振双,任国华,等.第一跖背(底)动脉蒂双叶皮瓣联合人工真皮修复相邻两手指中末节缺损[J].中华显微外科杂志,2014,37(4):360-363.DOI: 10.3760/cma.j.issn.1001-2036.2014.04.011.
    [14]
    蔡景龙.现代瘢痕学[M].北京:人民卫生出版社,2008:333.
    [15]
    周继红.创伤评分学[M].北京:科学出版社,2018:334.
    [16]
    EmersonRW.Likert scales[J].Journal of Visual Impairment &Blindness,2017,111(5):488.DOI: 10.1177/0145482X1711100511.
    [17]
    唐举玉.负压封闭引流技术在植皮和皮瓣移植中的应用[J].中华显微外科杂志,2014,37(3):215-217.DOI: 10.3760/cma.j.issn.1001-2036.2014.03.004.
    [18]
    汪华侨,常湘珍,朱庆棠,等.负压封闭引流技术专题座谈会专家意见[J].中华显微外科杂志,2014,37(3):209.DOI: 10.3760/cma.j.issn.1001-2036.2014.03.001.
    [19]
    LiZ,WuW,LiuS,et al.Effect of vacuum sealing drainage in dermatoplasty of large area of cutaneous defects[J].Int J Surg,2017,42:143-146.DOI: 10.1016/j.ijsu.2017.04.059.
    [20]
    王欢,夏芳,邢丹谋,等.负压封闭冲洗引流治疗手部急慢性化脓性腱鞘炎的疗效分析[J].中华外科杂志,2017,55(5):384-388.DOI: 10.3760/cma.j.issn.0529-5815.2017.05.015.
    [21]
    欧昌良,邹永根,罗成,等.负压封闭引流联合股前外侧穿支皮瓣修复足部软组织缺损[J].中国骨伤,2018,31(7):666-670.DOI: 10.3969/j.issn.1003-0034.2018.07.015.
    [22]
    李军,朱靓,徐明达,等.封闭负压固定技术在特殊部位植皮中的应用[J].中国美容医学,2013,22(14):1472-1475. DOI: 10.3969/j.issn.1008-6455.2013.14.002.
    [23]
    JohalH,KrederH.Cochrane in CORR®: negative pressure wound therapy for skin grafts and surgical wounds healing by primary intention[J].Clin Orthop Relat Res,2018,476(3):463-465.DOI: 10.1007/s11999.0000000000000187.
    [24]
    BiermannN,GeisslerEK,BrixE,et al.Oxygen levels during negative pressure wound therapy[J].J Tissue Viability,2019,28(4):223-226.DOI: 10.1016/j.jtv.2019.09.001.
    [25]
    袁东亮,赵耀华,邓海涛,等.自制负压封闭引流装置在八例上肢深度烧伤患者腹部带蒂皮瓣术后固定及引流中的应用[J].中华烧伤杂志,2019,35(8):611-613.DOI: 10.3760/cma.j.issn.1009-2587.2019.08.011.
    [26]
    柴家科,申传安.重视负压伤口治疗技术在烧伤外科中的应用[J].中华烧伤杂志,2015,31(2):81-83.DOI: 10.3760/cma.j.issn.1009-2587.2015.02.001.
    [27]
    中华医学会烧伤外科学分会,《中华烧伤杂志》编辑委员会.负压封闭引流技术在烧伤外科应用的全国专家共识(2017版)[J].中华烧伤杂志,2017,33(3):129-135.DOI: 10.3760/cma.j.issn.1009-2587.2017.03.001.
    [28]
    桑井贵,鲁凯伍,邵卫,等.躯干石膏综合征的临床探讨[J].中国综合临床,2002,18(2):171-172.DOI: 10.3760/cma.j.issn.1008-6315.2002.02.050.
    [29]
    JaffeL,WuSC.Dressings, topical therapy, and negative pressure wound therapy[J].Clin Podiatr Med Surg,2019,36(3):397-411.DOI: 10.1016/j.cpm.2019.02.005.
    [30]
    仇申强,孙文海,孙法威, 等.髂腹部带蒂皮瓣结合VSD技术在上肢创面修复中的应用[J].中华显微外科杂志,2016,39(2):165-167.DOI: 10.3760/cma.j.issn.1001-2036.2016.02.017.
    [31]
    赵宇辉,李莉,刘淑岩,等.改良封闭负压引流技术在腹部皮瓣供瓣区的临床应用[J].中国美容医学,2013,22(1):130-132.DOI: 10.3969/j.issn.1008-6455.2013.01.052.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(1)  / Tables(3)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (229) PDF downloads(50) Cited by()
    Proportional views
    Related

    Copyright © Chinese Journal of Burns京ICP备07035254号-14

    E-mail：shaoshangzazhi@163.com

    Website：https://zhsszz.xml-journal.net/

    Supported by: Beijing Renhe Information Technology Co. Ltd    

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return