Objective: To summarize the effectiveness of delayed skin-stretching device in treatment of skin and soft tissue defects.
Methods: Between December 2014 and December 2016, 10 cases of skin and soft tissue defects were treated with delayed skin-stretching device. There were 6 males and 4 females with an average age of 53 years (range, 42-64 years). The skin and soft tissue defects were caused by acute trauma in 6 cases. The incision could not be closed directly after making incisions because of osseous fascia syndrome in 3 cases. The skin soft tissue defect caused after huge carbuncle incision and drainage in 1 case. The defect located at thigh in 4 cases, lower leg in 3 cases, upper arm in 2 cases, back in 1 case. The defect area ranged from 10 cm×4 cm to 22 cm×12 cm. Pinch test was performed on the wound margin, which confirmed that the wound could not be closed directly.
Results: Tension blisters were found in 3 cases during traction, and no complications such as impaired blood circulation or skin necrosis occurred in all cases. Skin defects closed directly after continuously stretching for 7-18 days. No skin graft or free flap repair was performed in all patients. The wound healed well after operation. All the 10 patients were followed up 5-8 months (mean, 6.5 months). There was no necrosis around the wound margin and the scar was linear. The sensation and function were not affected.
Conclusion: Delayed skin-stretching device is an effective method to treat skin and soft tissue defects, which has the advantages of simple operation, lower risk of operation, less complications, and reliable effectiveness.
目的: 总结延时皮肤牵拉器治疗皮肤软组织缺损的临床效果。
方法: 2014 年 12 月—2016 年 12 月，采用延时皮肤牵拉器治疗皮肤软组织缺损 10 例。男 6 例，女 4 例；年龄 42～64 岁，平均 53 岁。急性创伤致皮肤软组织缺损 6 例，骨筋膜室综合征切开后切口无法闭合 3 例，巨大痈切开引流后皮肤软组织缺损 1 例。缺损部位：大腿 4 例，小腿 3 例，上臂 2 例，背部 1 例。缺损范围为 10 cm×4 cm～22 cm×12 cm。创缘行 Pinch 试验，确认创面均无法直接闭合。
结果: 牵拉过程中，3 例出现张力性水疱；无创缘血运不畅、皮肤坏死等并发症发生。10 例患者创面经过 7～18 d 持续牵拉后明显缩小，均直接拉拢缝合；无植皮或游离皮瓣手术者。术后创口愈合良好。10 例患者均获随访，随访时间 5～8 个月，平均 6.5 个月。创缘周围均无坏死，瘢痕呈线性，感觉及功能不受影响。
结论: 采用延时皮肤牵拉器治疗皮肤软组织缺损操作简便、手术风险低、并发症少，可获得较好疗效。
Keywords: Skin and soft tissue defect; delayed skin-stretching device; skin stretching.