| Objective In this study,the changes of positive pressure under the new expanded skin flap blood circulation training device with different length under different negative pressure intensity were observed.to explore the feasibility of the new expanded skin flap blood circulation training device(that is,whether it can provide sufficient and stable pressure to block the blood flow on the surface of the expanded skin flap),so as to provide scientific basis and data support for the feasibility and accurate implementation of the new expanded skin flap blood circulation training device.The blood circulation training device of the new expanded skin flap was used to train the blood circulation of the expanded skin flap,and the clinical effect of the new expanded skin flap blood circulation training device was observed so as to provide a new idea for the blood circulation training of the expanded skin flap.Methods This experiment is divided into two parts: the first part: the pressure measurement under the new expanded skin flap blood circulation training device: the change of the positive pressure value under the new expanded skin flap blood circulation training device in 20 volunteers under different negative pressure intensity of the right forearm was measured.The measured data were statistically analyzed,and the changes of positive pressure value under different negative pressure conditions and different distances from the connection point were observed.The difference and correlation between the positive pressure under the device and the length of the device and the intensity of negative pressure applied were analyzed respectively,so as to provide scientific basis and data support for the feasibility and accurate implementation of the new expanded skin flap blood supply training device.The second part: the clinical observation of the new expanded skin flap blood circulation training device: through 11 patients,a total of 14 cases of expanded skin flap were treated with the new expanded skin flap blood circulation training device.After the completion of blood circulation training,skin flap transfer was performed to repair skin defects.There were 7 males and 4 females,with an average age of 30.5 years old.2 cases of scar contracture of neck,1 case of scar contracture of back of neck,4 cases of scar contracture of abdomen,2 cases of scar contracture of left upper limb,1 case of scar contracture of right lower limb,3 cases of scar contracture of chest,1 case of keloid in chest.The maximum area of expanded flap was 32 × 12 cm,and the maximum ratio of length to width was 4:1.The donor area of the flap was sutured directly.The complications during vascularization training and the survival of skin flap after operation were observed and recorded.The patients were followed up for 18 months with an average of 10.4 months.Results 1 Measurement of the pressure under the new expanded skin flap blood circulation training device:(1)the new expanded skin flap blood circulation training device can produce positive pressure on the skin and soft tissue,and there is a significant positive correlation between the positive pressure and the negative pressure under the device.The maximum positive pressure under the device is 9.173 kpa,which is greater than the capillary perfusion pressure(3.33-4.00kpa)on the surface of the expanded flap.(2)the positive pressure of the new expanded skin flap with different distance from the connection point(cm)showed no significant difference under the blood circulation training device,and there was no correlation between the positive pressure under the device and the distance from the connection point(cm),indicating that the positive pressure under the device with different length was balanced and stable.(3)the new blood circulation training device of expanded skin flap can provide sufficient and stable positive pressure to block the blood flow on the surface of expanded skin flap and achieve the purpose of blood circulation training.2 observation on the clinical curative effect of the new expanded skin flap blood circulation training device: 14 cases of skin flaps completed the blood circulation training.Among them,tension blisters appeared on the surface of expanded flaps in 4 cases during vascularization training,skin allergy occurred in 2 cases,and subflap hematoma occurred in 1 case due to poor braking of the flap after flap transfer.it leads to blood circulation disturbance and distal local necrosis of the distal end of the flap.However,no serious complications such as dilator rupture,flap necrosis,flap infection and other serious complications were found in 14 cases of expanded skin flap during blood circulation training,and no abnormal color change and blood circulation disturbance were found during and after flap excision.Among them,13 cases survived 100% after flap transfer,and the incisions in the donor area of 14 cases healed in the first stage.All the 14 flaps were followed up for 18 months(mean 10.4 months).The color and texture of the flap are similar to those of the surrounding normal tissue,and the repair effect is satisfactory.Conclusion 1 The positive pressure produced by the new expanded flap blood training device on skin and soft tissue was successfully measured,and the positive pressure provided by the device was greater than that by the vascular perfusion through the surface of the flap.The positive pressure was distributed evenly under the device without any effect of length,that is to say,the device can provide enough and stable pressure to block the blood supply of expanded skin flap,which provides theoretical basis and data support for the clinical application of the new device.2 The new expanded flap blood supply training device can improve the expanded flap blood supply,improve the expanded flap survival rate,compared with the traditional flap delay surgery,has the advantages of noninvasive,adjustable,easy to operate,minor complications.It is important to reduce the pain,improve the compliance,reduce the risk of operation,reduce the length of stay and reduce the financial burden.To provide a new idea for the training of expanded flap blood supply.Figure 41;Table 15;Reference 90... |
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