The Clinical Characteristics Of The Complex Chest Wall Tuberculosis Wound And The Preliminary Exploration Of Using Plastic Surgery And Wound Healing To Repair

Objective:Through the use of Wound healing techniques(focal debridement + the VSD) joint Plastic surgery techniques(transfer of skin flap, skin graft, flap stuffing, etc),to treat complex wounds of the chest wall tuberculosis,explore clinical features of the Tuberculous chest wound, the feasibility and effectiveness of treatments.Methends:Collect chest wall tuberculosis clinical data of 11 cases of hospitalized patients who were treated comprehensive therapy durning 2012-2014,Analysis condition prior to admission,lesion characteristics, characteristics, preoperative, intraoperative and postoperative wound detection, intraoperative and postoperative complications, the length of the other, follow-up.Results:11 cases of tuberculosis chest wounds,Wound incubation period:ncubation period(3cases) : for 21 days, 30 days, half a year;6 cases of fistula,2 cases of bag piece,2 cases of Bag piece with fistula;1 case of Longitudinal incision;The detections of wound secretion of 7cases:5 cases have no bacteria,2 cases Tips:G+bacterial infection;7 cases were did chest CT,performancing the sternum, costal local shape was expansive, irregular bone destruction,Seenadjacent curved or fusiform soft tissue density,1 case of pleural multiple nodules;6 cases of ultrasonic tips subcutaneous hypoechoic areas, having uneven shape echo and Less clear edge;Histopathology:4 cases were granulomatous lesions,Acid-fast staining(-);4 cases were granulomatous lesions,Acid-fast staining(+);2 cases of fat and fibrous tissue,Seen a small amount of lymphocytic infiltration;2 cases of inflammatory granulation tissue;1 case of fat and fibrous tissue, seen no obvious lesions;Preoperative preparation time:2±1days. 11 cases of Lesion debridement + VSD suction drainage + local flap repair(skin grafting),10 cases were cured,1 case was improved,The response rate was 90.90%;the time of removing:8±2days.Remove the time:8±2days.one case’s intercostals arterie is Injuried in the process of operation.1 case of recurrence.The average total number of days of hospitalization:28.091±15.385 days,The average total cost of hospitalization:27773.727±12133.032 yuan,The average frequency of dressing change:13.818±8.183 times.following up Cured patients for 3-34 months,No recurrence.Conclusions:Chest wall tuberculosis wound is a kind of complex painless wound;The specific diagnosis of disease is lack, it need to combine history, imaging, tissue pathology, laboratory examination and so on to comprehensive diagnosis;using of Wound healing techniques joint Plastic surgery techniques is an effective treatment method;The method has good therapeutic effect to the wound that Lesions deeply infiltrat,suggest that applied in clinical practice.