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目的:探讨负压封闭引流技术应用于躯干部皮肤恶性肿瘤切除术的临床效果,并分析其临床应用价值。方法:回顾性分析2012年5月~2015年3月我院收治的11例躯干部皮肤恶性肿瘤患者的临床资料,均予行肿物切除术并同时行自体皮游离移植术,并外用持续负压封闭引流术于植皮术区。结果:所有患者均接受肿物切除+植皮+封闭负压引流技术治疗。9例患者于4~9天后拆除负压材料,皮片全部成活。1例患者治疗后24小时内吸引管堵塞,经术后于24小时内行管路冲洗疏通后再次行负压吸引,于术后5天首次拆除负压材料,见皮片部分成活,部分皮片仍有浮动,血运未明显建立,予以扩大皮片引流孔后再次行负压封闭引流术,术后9天再次拆除负压材料,见皮片成活较好。1例患者治疗4天后出现新鲜渗血经引流管引出,予拆除负压材料,所植皮片下有积血块,有新鲜渗血,予以清创后再次行负压封闭引流术,术后9天再次拆除负压材料,见皮片成活较好。随访半年到3年,所植皮片无破溃,肿瘤无复发。结论:躯干部皮肤恶性肿瘤切除术中,植皮联合封闭式负压引流技术可使所植皮片固定确实,充分引流渗液积血,利于皮片成活,对无法有效包扎固定肢体特殊部位(肩部、臀部、躯干部)等术区植皮提供了有效方法,具有一定的推广应用价值。
Objective: To investigate the clinical effect of negative pressure closed drainage technique applied to the removal of skin cancer of the trunk and to analyze its clinical value. Methods: The clinical data of 11 patients with malignant tumors of the trunk in our hospital from May 2012 to March 2015 were retrospectively analyzed. All patients underwent resection of the tumor with autologous skin graft and external continuous negative pressure Closed drainage in the skin graft area. Results: All patients underwent tumor resection + skin grafting + closed negative drainage technique. Nine patients underwent removal of negative pressure material after 4 to 9 days and all skin pieces survived. One patient suffered a blockage of the suction tube within 24 hours after treatment. After a 24-hour postoperative flushing procedure, the negative pressure was again taken in. A negative pressure material was removed for the first time after 5 days, and some skin pieces were found alive Still floating, blood supply was not significantly established, to expand the drainage holes and then negative pressure drainage and drainage again, 9 days after the removal of negative pressure material again, see the skin survived better. One patient was treated for 4 days after the emergence of fresh bleeding through the drainage tube leads to the removal of negative pressure material, the graft under the hematoma, fresh bleeding, to be debrided again under negative pressure drainage and drainage after 9 days Once again remove the negative pressure material, see the skin survived better. Follow-up six months to 3 years, the skin graft without ulceration, no recurrence of the tumor. CONCLUSION: In skin and oncology, skin grafting combined with closed negative pressure drainage technique can make the skin graft firmly fixed, fully drain the exudate and hemorrhage, which will benefit the survival of the skin graft. It is not effective in dressing and fixing the special parts of the limbs , Buttocks, trunk) and other surgical skin graft provides an effective method, with some promotion and application value.