负压封闭引流技术在躯干部皮肤恶性肿瘤切除术中的应用

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。

Application of VacuumSealing Drainage Technology in Resection of the Trunk Skin Malignant Tumor

Objective:To investigate the clinical effect of vacuumsealing drainage in the treatment of malignant tumor of the body and analyze its clinical application value.Methods:The clinical data of 11 cases of patients with trunk skin malignant tumors admitted in our hospital from May 2012 to March 2015 were chosen. They were treated with operation of tumor resection and simultaneous removal of autologous skin graft, at the same time, the topical continuous vacuumsealing drainage were also used in the skin grafting area.Results:All patients underwent tumor resection + skin grafting + vacuum sealing drainage. The negative pressure material was removed in 9 patients after 4~9 days, and all the skin grafts survived. The suction tube was blockage in one patient within 24 hours and was flushed after the pipeline, the negative pressure was drawn again. The negative pressure material was removed 5 days after the operation and parts of the skin grafts survived, others were still floated and the blood flow was not obvious. After the drainage of skin, the negative pressure sealing drainage was performed, and the negative pressure was removed 9 days after operation. The fresh blood seeping through the drainage pipe was found in one patient and the negative pressure material was removed. Blood clots were found in skin pieces and fresh oozing of blood was also found. Another negative pressure closed drainage was given and the negative pressure material was removed 9 days after operation, the skin grafts survived well. Follow up for half a year to 3 years, all the skin grafts were without ulceration and the tumor was recurrence.Conclusion:Malignant neoplasms of skin of trunk resection surgery and skin grafting combined with closed negative pressure drainage technology could make the skin graft fixation indeed, adequate drainage infiltration liquid accumulation of blood, in favor of skin graft survival, to can not effectively bandage fixed body special parts (shoulders, hips, trunk) operation of the graft site provides effective method, has certain value of popularization and application.