皮能快愈敷料（PELNAC）修复指端缺损效果的临床研究
发布时间：2019-03-03 12:42
【摘要】：目的:通过与传统经典的邻指、腹部、岛状皮瓣及原位回植手术方法对照,研究分析人工真皮(PELNAC)修复手指指端缺损的临床治疗效果方法:回顾性分析总结2013年6月一2014年12月我科指端缺损治疗的病例,在尽可能排除年龄、营养状况、经济、职业因素等差异下,随机的选出以Pelnac修复指端缺损而治愈的20例患者临床资料,在类似部位、类似损伤的经传统邻指、腹部、岛状皮瓣转移术及原位回植而治愈的患者中,随机选出邻指皮瓣20例、腹部皮瓣患者20例、岛状皮瓣20例及原位回植成活20例患者(2例随访丢失,故有效数据为18例患者)的资料作为对照组。Pelnca治疗组创面均急诊行清创+Pelnac覆盖术,术后4周拆除硅胶膜,伤口每三天换药一次,待创面自然上皮化。对五组患者术后进行12-18个月的随访并加以对比分析。使用spss19.0软件包加以统计分析。结果:pelnac治疗组术后无主要并发症,颜色及质地有效比为100%,上皮化时间为20.95±3.78天,Pelnac治疗指端缺损的有效率为100%,感觉恢复在S3-S3+。Pelnac治疗组与其他治疗组相比,Pelnac组疤痕得分低于其他组(P0.05);伤口愈合时间Pelnac组长于其他组(PO.05);住院时间Pelnac组短于其他组(PO.05);Pelnac组患指功能锻炼时间早于其他组(PO.05);Pelnac组DIP及总TAM要优于其他组(PO.05);;Pelnac组愈后外观好于其他组(P0.05)。患者住院费用,Pelnac组高于原位回植组(P0.05),与岛状皮瓣组无明显统计学意义(P0.05),低于邻指皮瓣及腹部皮瓣组(P0.05)患者手术时间,Pelnac组与原位回植组无明显统计学差异(P0.05),短与其他治疗组(P0.05)结论:1、Pelnac修复手外伤中指端缺损,手术操作简单,手术时间短,住院时间短,创伤小,术后患指外观、感觉良好。2、Pelnac治疗方法一次手术完成,无需二次手术,易于在基层推广。3、Pelnac治疗方法患者术后患指指间关节可早期活动及功能锻炼,患指活动及功能恢复良好4、Pelnac治疗方法伤口愈合周期长,无菌要求高,费用较高。
[Abstract]:Objective: to compare the traditional methods of orthopedic orthotopic replantation with that of adjacent finger, abdomen, island skin flap and in situ replantation. Study and analysis of the clinical effect of artificial dermis (PELNAC) in the repair of finger tip defect: retrospective analysis of the treatment of finger end defect in our department from June 2013 to December 2014, excluding age, nutritional status and economy as far as possible, Under different occupational factors, the clinical data of 20 patients who were cured by Pelnac repair of finger end defect were randomly selected. In the patients with similar site, similar injury through traditional adjacent finger, abdomen, island flap transfer and in situ replantation, the clinical data were selected randomly, and the clinical data of 20 patients cured by repair of finger end defect with similar injury were randomly selected. There were 20 cases of adjacent finger flap, 20 cases of abdominal flap, 20 cases of island flap and 20 cases of survival after in situ replantation. All the wounds in the Pelnca treatment group were treated with debridement Pelnac coverage, and the silicone film was removed 4 weeks after operation. The wound was changed every three days until the wound was naturally epithelized. Five groups of patients were followed up for 12 months and 18 months after operation and compared with each other. Spss19.0 software package was used for statistical analysis. Results: there were no major complications in the pelnac group, the effective ratio of color to texture was 100%, the epithelization time was 20.95 卤3.78 days, and the effective rate of Pelnac in the treatment of fingertip defect was 100%. Compared with other groups, the scar score in S3-S3 group was lower than that in other groups (P0.05), and the score of scar in Pelnac group was lower than that in other groups (P0.05). The time of wound healing was longer in Pelnac group than in other groups (PO.05), and the duration of hospitalization in Pelnac group was shorter than that in other groups (PO.05); Pelnac group was earlier than that in other groups (PO.05); Pelnac group DIP and total TAM) was better than other groups (PO.05); group). The appearance of Pelnac group after recovery was better than that of other groups (P0.05). The cost of hospitalization in the Pelnac group was higher than that in the in situ graft group (P0.05), and there was no significant difference between the island flap group and the island flap group (P0.05), but it was lower than that in the adjacent finger flap and abdominal flap group (P0.05). There was no significant difference between Pelnac group and in situ replantation group (P0.05). Conclusion: 1Pelnac has the advantages of simple operation, shorter operation time, shorter hospital stay and less trauma. The appearance of the affected finger after operation is good. 2, the Pelnac treatment method is completed in one operation, does not need the second operation, and is easy to be popularized at the basic level. 3, the patients with Pelnac treatment can have early movement and functional exercise of the interphalangeal joint after operation. The activity and function of the affected finger recovered well. Pelnac treatment had a long healing period, high aseptic requirement and high cost.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R658.2
本文编号：2433704
[Abstract]:Objective: to compare the traditional methods of orthopedic orthotopic replantation with that of adjacent finger, abdomen, island skin flap and in situ replantation. Study and analysis of the clinical effect of artificial dermis (PELNAC) in the repair of finger tip defect: retrospective analysis of the treatment of finger end defect in our department from June 2013 to December 2014, excluding age, nutritional status and economy as far as possible, Under different occupational factors, the clinical data of 20 patients who were cured by Pelnac repair of finger end defect were randomly selected. In the patients with similar site, similar injury through traditional adjacent finger, abdomen, island flap transfer and in situ replantation, the clinical data were selected randomly, and the clinical data of 20 patients cured by repair of finger end defect with similar injury were randomly selected. There were 20 cases of adjacent finger flap, 20 cases of abdominal flap, 20 cases of island flap and 20 cases of survival after in situ replantation. All the wounds in the Pelnca treatment group were treated with debridement Pelnac coverage, and the silicone film was removed 4 weeks after operation. The wound was changed every three days until the wound was naturally epithelized. Five groups of patients were followed up for 12 months and 18 months after operation and compared with each other. Spss19.0 software package was used for statistical analysis. Results: there were no major complications in the pelnac group, the effective ratio of color to texture was 100%, the epithelization time was 20.95 卤3.78 days, and the effective rate of Pelnac in the treatment of fingertip defect was 100%. Compared with other groups, the scar score in S3-S3 group was lower than that in other groups (P0.05), and the score of scar in Pelnac group was lower than that in other groups (P0.05). The time of wound healing was longer in Pelnac group than in other groups (PO.05), and the duration of hospitalization in Pelnac group was shorter than that in other groups (PO.05); Pelnac group was earlier than that in other groups (PO.05); Pelnac group DIP and total TAM) was better than other groups (PO.05); group). The appearance of Pelnac group after recovery was better than that of other groups (P0.05). The cost of hospitalization in the Pelnac group was higher than that in the in situ graft group (P0.05), and there was no significant difference between the island flap group and the island flap group (P0.05), but it was lower than that in the adjacent finger flap and abdominal flap group (P0.05). There was no significant difference between Pelnac group and in situ replantation group (P0.05). Conclusion: 1Pelnac has the advantages of simple operation, shorter operation time, shorter hospital stay and less trauma. The appearance of the affected finger after operation is good. 2, the Pelnac treatment method is completed in one operation, does not need the second operation, and is easy to be popularized at the basic level. 3, the patients with Pelnac treatment can have early movement and functional exercise of the interphalangeal joint after operation. The activity and function of the affected finger recovered well. Pelnac treatment had a long healing period, high aseptic requirement and high cost.
【学位授予单位】：华中科技大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R658.2
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