封闭负压引流联合网状皮片移植在四肢皮肤脱套伤修复中的应用  

Application of vacuum sealing drainage combined with mesh skin graft in extremities degloving injure

作　　者：修一平[1,2] 李万同[2] 王恩华[1] 

机构地区：[1]中国医科大学基础医学院病理学教研室,沈阳110001 [2]沈阳军区总医院烧伤与创面修复外科

出　　处：《中国临床实用医学》2014年第3期33-34,共2页China Clinical Practical Medicine

摘　　要：目的：探讨应用封闭负压引流联合网状植皮治疗四肢皮肤脱套伤，代替传统加压包扎回植中厚网状皮片的应用效果。方法回顾2010年8月至2013年6月沈阳军区总医院应用封闭负压引流（VSD）联合中厚网状皮片移植修复四肢皮肤脱套伤24例，其中男16例，女8例，年龄19～56岁。利用封闭负压引流技术代替传统加压包扎技术，7～10 d 后拆除 VSD 装置，观察治疗后植皮成活情况。结果24例患者中16例经过1次手术完成创面覆盖，6例经过2次手术完成创面覆盖，2例患者因肢体挤压伤严重，回植皮片小面积成活且伴有肌肉肌腱外露，后经多次游离植皮及游离皮瓣转移术消灭创面。结论封闭式负压引流技术联合网状皮片移植治疗外伤导致的四肢皮肤脱套伤，能对皮片均匀加压并充分引流坏死组织，起到控制感染、促进植皮成活的效果，值得临床推广。Objective Toexploretheapplicationofvacuumsealingdrainage(VSD)combinedwith mesh skin graft on treating with limbs skin degloving injury, instead of yarn package pressurized technology. Methods From August 2010 to June 2013, there were 24 cases of patients with limbs skin degloving injury, including 16 males and 8 females, aged 19~56 years. All the patients were treated with the vacuum sealing drainage instead of yarn package pressurized technology, 7~10 days later,dismantling the VSD device,to record skin graft survival after treatment. Results 16 cases in 24 patients completed coverage of the wound after an operation, 6 cases completed coverage of the wound after two operation. Two patients due to severe crush injuries, a small area of grafted skin survived and accompanied by slices of muscle tendon exposure, after several free skin graft and free flap transfer surgery to eliminate wound. Conclusion Vacuum sealing drainage combined with mesh skin graft on treating with limbs skin degloving injury, can uniform pressure and adequate drainage of necrotic tissue,and control the infection, then promote the survival of grafted skin, worthy of clinical promotion.

关 键 词：封闭负压引流技术 脱套伤 网状皮片移植 修复 

分 类 号：R64[医药卫生—外科学] R75[医药卫生—临床医学]