Liao Xincheng,Jiang Zhengying,Fu Zhonghua,et al.Efficacy observation of negative pressure wound therapy combined with skin grafting for the treatment of large-scale skin avulsions in children[J].Journal of Clinical Pediatric Surgery,,():1062-1067.[doi:10.3760/cma.j.cn101785-202405030-011]
Efficacy observation of negative pressure wound therapy combined with skin grafting for the treatment of large-scale skin avulsions in children
- Keywords:
- Child; Skin Avulsion; Negative Pressure Wound Therapy; Skin Grafting; Efficacy
- Abstract:
- Objective To explore the efficacy and surgical experience of combining negative pressure wound therapy (NPWT) with skin grafting in the treatment of large-scale skin avulsions in children. Methods A retrospective analysis was conducted on the clinical data of 40 children with large-scale skin avulsions who were treated at the Medical Center of Burn Plastic Surgery and Wound Repair of the First Affiliated Hospital of Nanchang University from June 2018 to June 2023.All patients underwent thorough debridement in the emergency operating room,with split-thickness skin grafting and NPWT applied.Outcomes observed included skin graft survival at 14 days post-surgery,granulation growth time,NPWT treatment duration,wound healing time,and hospital stay.Follow-up assessments at 8 months included skin color,elasticity subcutaneous fullness,scar proliferation,and joint function.Levels of inflammatory factors and bacterial detection rates in the grafted areas were also measured. Results Among the 40 children,29 had complete skin graft survival (29/40,72.50%),and 25 had surviving grafts with blood supply (25/40,62.50%).The overall skin graft survival rate was (85.18±2.18)%,with granulation growth time of (8.55±1.18) days,wound healing time of (21.55±6.37) days,NPWT treatment duration of (19.55±6.02) days,and hospital stay of (36.25±3.18) days.There was no statistically significant difference in the overall bacterial detection rate during NPWT compared to before treatment (P>0.05).No severe complications were reported;2 cases had initial wound infections,and 1 case had mild pressure sores during hospitalization.Follow-up duration exceeded 8 months,with skin color scores of (2.63±0.63) and skin texture scores of (2.85±0.36).Levels of Interleukin-6 (IL-6),Interleukin-23 (IL-23),and tumor necrosis factor-α (TNF-α) decreased significantly after treatment compared to before,with values of (102.26±12.21 vs.58.93±7.44),(182.54±13.52 vs.110.74±10.25),and (6.92±0.47 vs.4.57±0.52),respectively (P<0.05). Conclusions The combination of NPWT and skin grafting is effective in promoting granulation tissue repair,achieving high graft survival rates,reducing infection rates,and improving graft adherence.It shows good clinical application value for treating large-scale skin avulsions in children.
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Memo
收稿日期:2024-5-14。
基金项目:国家自然基金地区科学基金项目(82160380);江西省中医药管理局科技计划(2023B0821)
通讯作者:郭光华,Email:gggg2024@126.com