Securing split thickness skin grafts using negative-pressure wound therapy without suture fixation
Securing split thickness skin grafts using negative-pressure wound therapy without suture fixation
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DOI：
10.12968/jowc.2019.28.sup8.s16
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发表时间：
2019-08-01
影响因子：
1.9
通讯作者：
Yoshida, Sei
中科院分区：
文献类型：
--
作者：
Inatomi, Yusuke;Kadota, Hideki;Yoshida, Sei
目的：负压创面治疗（NPWT）通常作为裂厚皮肤移植（STSG）在缝合或皮钉固定后的支撑。在本研究中，NPWT应用于固定STSGs，无需任何缝合或订书钉。不缝合使用NPWT的手术效果与对照组进行比较。方法：将STSGs患者分为两组：仅使用NPWT的“不缝合”组和使用常规固定物的对照组。不缝合组用网孔创面敷料和药膏覆盖。NPWT泡沫放置在STSG上并施加负压。在对照组中，使用搭接支撑固定移植物，缝合后用纤维蛋白胶或NPWT固定。结果：共30例患者，35个移植部位参与研究。无缝线组平均植皮率为95.1%，对照组平均植皮率为93.3%，两组差异无统计学意义。未缝合组未发生移植物剪切。虽然差异无统计学意义，但不缝合组平均手术时间（31.5分钟）明显短于对照组（55.7分钟）。结论：通过消除缝线，缩短了手术时间，避免了缝合，不需要拆线，避免了手术带来的疼痛。此外，避免了钉钉滞留及其相关并发症的可能性，使该方法对医务人员和患者都有潜在的好处。
Objective: Negative-pressure wound therapy (NPWT) is generally applied as a bolster for split-thickness skin grafts (STSG) after the graft has been secured with sutures or skin staples. In this study, NPWT was applied to secure STSGs without any sutures or staples. Surgical outcomes of using NPWT without sutures was compared with a control group.Methods: Patients with STSGs were divided into two groups: a 'no suture' group using only NPWT, and a control group using conventional fixings. In the no suture group, the grafts were covered with meshed wound dressing and ointment. The NPWT foam was placed over the STSG and negative pressure applied. In the control group, grafts were fixed in place using tie-over bolster, securing with fibrin glue, or NPWT after sutures.Results: A total of 30 patients with 35 graft sites participated in the study. The mean rate of graft take in the no suture group was 95.1%, compared with 93.3% in the control group, with no significant difference between them. No graft shearing occurred in the no suture group. Although the difference did not reach statistical significance, mean surgical time in the no suture group (31.5 minutes) tended to be shorter than that in the control group (55.7 minutes).Conclusion: By eliminating sutures, the operation time tended to be shorter, suturing was avoided and suture removal was not required meaning that patients could avoid the pain associated with this procedure. Furthermore, the potential for staple retention and its associated complications was avoided, making this method potentially beneficial for both medical staff and patients.