皮瓣移植修复与植皮联合负压引流治四肢复合组织损伤的双盲、随机[摘要]目的观察皮瓣移植修复与植皮联合负压引流治四肢复合组织损伤的双盲、随机比较。方法整群选取2013年2月―2015年11月该院骨科收治的108例四肢复合组织损伤患者，双盲随机法分为两组各54例，对照组行皮瓣移植修复术治疗，观察组另行植皮联合负压引流术治疗，观察两组各项指标，并观察术前、后两组VAS疼痛评分比较，同时观察术后并发症发生情况。结果观察组下床活动时间（28.15±11.68）h较对照组显著长（P<0.05），创面愈合时间（22.81±3.21）d、换药次数（8.45±1.23）次分别均较对照组显著短（P<0.05）；术后两组VAS评分分别均较术前显著减小，且观察组VAS评分（6.56±0.25）分、（4.26±0.36）分、（2.01±1.01）分分别均较对照组减小显著，均差异有统计学意义（P<0.05）；观察组术后并发症发生率1.85%较对照组12.96%显著低（P<0.05）。结论植皮联合负压引流可显著延长四肢复合组织损伤患者的下床活动时间，同时显著减少创面愈合时间、换药次数、术后VAS评分及术后并发症发生率，具有临床推广应用价值。[关键词]四肢复合组织损伤；负压引流；皮瓣移植修复[]R5[文献标识码]A[]1674-0742（2016）05（b）-0066-03[Abstract]ObjectiveToobservethedouble-blindandrandomcomparisonofskinflapgraftingrepairandskin-graftingcombinedwithnegativepressuredrainageintreatmentofextremitiescomplextissuedamage.Methods108casesofpatientswithextremitiescomplextissuedamageadmittedandtreatedinthedepartmentoforthopaedicsofourhospitalfromFebruary2013toNovember2015wereselectedandrandomlyanddouble-blindlydividedintotwogroupswith54casesineach，thecontrolgroupweretreatedwithskinflapgraftingrepair，theobservationgroupweretreatedwithskin-graftingcombinedwithnegativepressuredrainage，andthevariousindexesincludingthetimeofleavingbed，woundhealingtimeandfrequencyofdressingchangeandthecomparisoninVASpainscoresbeforeandafteroperationofthetwogroupswereobserved，atthesametime，theoccurrenceofpostoperativecomplicationswasobserved.ResultsThetimeofleavingbedintheobservationgroupwas（28.15±11.68）h，whichwasobviouslylongerthanthatinthecontrolgroup，P<0.05，thewoundhealingtimeandfrequencyofdressingchangeintheobservationgroupwererespectively（22.81±3.21）dand（8.45±1.23），whichwereobviouslyshorterthanthoseinthecontrolgroup，P<0.05，theVASscoreafteroperationofthetwogroupswereobviouslydecreasedcomparedwiththosebeforeoperation，theVASscoresintheobservationgroupwererespectively（6.56±0.25）marks，（4.26±0.36）marksand（2.01±1.01）marks，andthedecreasesoftheVASscoresintheobservationgroupweremoreobviousthatthoseinthecontrolgroupwithstatisticalsignificance，P<0.05，andtheincidencerateofpostoperativecomplicationsintheobservationgroupwasobviouslylowerthanthatinthecontrolgroup，（1.85%vs12.96%），P<0.05.ConclusionSkin-graftingcombinedwithnegativepressuredrainagecanobviouslyprolongthetimeofleavingbedinpatientswithextremitiescomplextissuedamage，atthesametime，obviouslydecreasethewoundhealingtime，frequencyofdressingchange，postoperativeVASscoreandincidencerateofpostoperativecomplications，whichisworthclinicalpromotionandapplication.[Keywords]Extremitiescomplextissuedamage；Negativepressuredrainage；Skinflapgraftingrepair四肢复合组织损伤是临床中骨科常见损伤之一，主要是指软组织及骨骼肌肉受到直接或间接压力或由慢性劳损所引起的创伤性综合征。组织损伤易出现无菌性炎症、微循环障碍及局部组织肿胀酸痛，损伤后较难处理加之合并骨及肌腱外露，使其处理更加棘手[1]。临床中传统治疗方式主要是清创换药，待创面清洁创面肉芽组织生长较好后再行植皮或皮瓣手术以闭合创面，...