METHODS: A 22-year-old Asian man sustained 25% total-body-surface-area flame burns. After multiple operations, an ulcer was present on the proximal left thigh. On day 37 after admission, the ulcer was debrided, and an 11/1000-inch (0.28 mm) skin graft was taken from the ipsilateral thigh and meshed, using a 1:1.5 ratio. NPWT was applied to the donor and recipient sites with a continuous negative pressure of 125 mmHg. On day 43, NPWT was discontinued. The skin grafts were not identified on the surface of the granulation tissue. With topical ointment therapy, rapid epithelialization of the ulcer was observed as the granulation tissue regressed. On day 48, the recipient site had completely epithelialized.
CONCLUSIONS: The hypergranulation tissue rarely covered the meshed STSGs when the grafts were fixed by NPWT. In that case, immediate debridement should be avoided, and conservative treatment should be initiated.
方法:一名22岁的亚洲男子遭受了25%的全身表面积火焰烧伤。经过多次操作,左大腿近端有溃疡。入院后第37天,溃疡被清创,并从同侧大腿上取下11/1000英寸(0.28毫米)的皮肤移植物并进行网眼化,使用1:1.5的比例。NPWT以125mmHg的连续负压应用于供体和受体部位。在第43天,停止NPWT。未在肉芽组织的表面上鉴定皮肤移植物。局部软膏治疗,随着肉芽组织的退化,观察到溃疡的快速上皮化.在第48天,受体位点具有完全上皮化。
结论:当移植物被NPWT固定时,超肉芽组织很少覆盖网状STSGs。在这种情况下,应避免立即清创,应开始保守治疗。