Application Of Plastic Surgery In The Repair Of Acute And Chronic Large Skin And Soft Tissue Wounds

Research Objective:An acute,massive wound in the daily life,which is caused by trauma,burns and so on,as well as pressure sore,malignant tumor,infection caused by chronic huge wounds are common.But the wound is not healed,and the scar healing or healing after the healing will bring a heavy psychological burden to the patient.The continuous development of plastic surgery technology and the clinical application of wound repair,better improve the shape and function of wound healing,make the treatment level and treatment effect of acute and chronic wounds greatly improved.To explore the application of plastic surgery in repairing large skin and soft tissue defects.Research method:1.materialsResearch object selection collected during 2010-2017 in the affiliated hospital of Qingdao university burns orthopaedic treatment of 84 patients with acute or chronic huge wound,58 patients with male,female patients 24 cases,aged 1 to 88,and the average age of 43.70 years,course of diseases by 2 h-30 years.Among them,57 cases were chronic wound,including 34 cases of skin infection,21 cases of malignant tumor and 2 benign tumors.25 cases of acute wounds,including the scrotum,penis skin degloving injury in 2 cases,4 cases were foot skin necrosis of subcutaneous tissue,the foot skin laceration in 2 cases,the right face and right chest trauma after skin defect in 5 cases,electrically damaging 4 cases with your hands,and burn in 7 cases,animal bites tissue defect in 1 case.2.Surgical proceduresAccording to the different condition of wound,54 cases were treated with skin grafts(including thickness of edge,medium thickness,full thickness and stamp graft),15 cases with skin flap,2 case with latissimus dorsi myocutaneous flap,and 1 case with lamysma dorsi myocutaneous flap.2 case of sural neurovascular fasciocutaneous flap was transplanted with VSD myocutaneous flap,10 cases was treated with negative pressure blocking drainage technique and other plastic surgery methods were us ed to repair the skin and soft tissue default after resection.Preoperative treatment : General before the surgery,according to the wound clean wound dressing,debridement,hypertonic saline wet compress to relieve granulation tissue edema,create suitable initial conditions after wound healing.In order to improve the quality of life of the flap after operation,the pedicled flap can be designed with ultrasonic detection to mark the suitable vessels and assist the design of the flap before operation.Results:Among the 84 cases,54 cases were transplanted with skin grafts,1 case of skin grafts failed,and the rate of first-grade healing was 94.4%.There were 15 cases of skin flap transplantation or flap transplantation,no failure cases,and the first-rate healing rate was 73.33%.5 cases with pedicled skin flap and musculocutaneous flap transplantation were performed.There were 10 cases of negative pressure closed drainage technology,and the first-rate healing rate was 80%.One case which the sinus was formed due to chronic wound and was located near the perianal tissue.After surgical treatment,the sinus was still not healed completely,so it was transferred to anal enterology for further treatment.One patient went to the hospital at the higher level because the residual wound had not healed for a long time.One case was completely necrotic due to infection after operation.One case of scar healing after debridement was treated with debridement,and 2 case was discharged automatically,while the other cases were all healed in grade A after operation.Conclusion:On the basis of systematic treatment,patients with acute and chronic huge skin and soft tissue wounds were treated with plastic surgery techniques such as skin graft,skin flap transplantation,negative pressure sealing and drainage technique or various repair methods can quickly seal the wound,promote healing,and obtain satisfactory shape and functional repair,and improve the quality of life of the patients.