Clinmcal Efficacy Of Combined Iliac Bone Flap Transplantation Combined With Traditional Chinese Medicine In The Treatment Of Bone Defect Of Extremities.

Background:With the continuous economic development of our country,the incidence of limbs openness damage is on the rise,which companying with increasing cases of limbs skin defect,infected nonunion,bone defect,thereby increasing the difficulty of clinical treatment,and perplexing clinical doctors.The traditional healing mechanism,Creeping Substitution,plays poorly in the clinical therapy,especially for healing large bone defect(size>4 cm).In recent years,with the continuous development of medical technology,Microsurgical technique has been developed,which makes iliac composite flap be applied in repairing large area skin defect combined with large bone defect,and has gotten an ideal effect.Research shows that combining the iliac composite flap transplantation and the traditional Chinese medicine treatment,for blood-activating and stasis-dissolving,to repair limbs skin and born defects,helps to relieve patients’ pain and promote patients’ wound healing.But the conclusion needs further validation.Objective:To investigate the clinical effect of combining the iliac composite flap transplantation and the traditional Chinese medicine treatment,for blood-activating and stasis-dissolving,to repair limbs skin and born defects,and try to provide a method for the treatment of skin and bone defects of limbs.Methods:According to the random number method,sixty-four patients with skin and born defects of the extremities,treated by hospital from July 2008 to April 2015,was divided into two groups,Control group(n=32)and Observation group(n=32).Control group used conventional iliac free groin flap and autogenously iliac grafts to repair wounds;the observation group repaired wounds with the method of combining the iliac composite flap transplantation and the traditional Chinese medicine treatment,which have the blood-activating and stasis-dissolving functions.Visual Analog Scale(VAS)was used to evaluate patients’ pain in the different time points,before repairing and after repairing.Mangled extremity security score(MESS)was used to evaluate patients’ damage situation in the different time points,before repairing and after repairing.The hospital self-designed questionnaire was used to evaluate the satisfaction of the two groups,and analyzed the treatment effect of combining the iliac composite flap transplantation and the traditional Chinese medicine treatment to repair limbs skin and born defects,then all the obtained data were processed by SPSS18.0 software.Results:The effective rate of observation group was 96.88%compared with 81.25%in the control group,which reached the statistical significance(P<0.05).There was no statistical significance compared with the two groups’ VAS scores before treatment(P>0.05).The VAS scores of the observation group was lower than the control group’ s after 1 month,2 months and 3 months treatments(P<0.05).There was no statistical significance compared with the two groups’ MESS scores before repair(P>0.05).MESS scores of the observation group was lower than the control group’ s after 1 month,2 months and 3 months repair(P<0.05).Compared with the control group,the time of preoperative hospitalization and the postoperative hospitalization of the observation group were shorter,and hospitalization cost was less(P<0.05).During the three months after the repair,the complication rate of the observation group was 6.25%compared with 15.63%in the control group,which reached the statistical significance(P<0.05).During the three months after the repair,the survival rate of the skin flap of the observation group was higher than that in the control group(P<0.05).And the satisfaction rate of the observation group was 93.75%compared with 78.13%in the control group,which had the statistical significance(P<0.05).Conclusion:The method,combining the iliac composite flap transplantation and the traditional Chinese medicine treatment,which have the blood-activating and stasis-dissolving functions,to repair limbs skin and born defects,has ideal effect.It can help patients relieve pain,improve the limb function,improve the satisfaction of wound repair and the survival rate of the skin flap,and also ensure the flap color similar to the accepted area,and promote the patient first phase recovery.So it is worthy of popularization and application.