封闭式负压引流在治疗肢体离断伤软组织缺损中的应用  

Vacuum Sealing Drainge in the Treatment of Severe Soft Tissue Defect during Emergancy Replantation of Limbs

作　　者：乃比尔[1] 余国荣[1] 陶圣祥[1] 彭飞 

机构地区：[1]武汉大学中南医院骨科,武汉430071 [2]武汉市三医院骨科,武汉430060

出　　处：《医学新知》2007年第1期27-28,31,共3页New Medicine

摘　　要：目的观察封闭式负压引流技术(vacuum sealing drainge,VSD)处理肢体离断伤皮肤软组织缺损创面的效果。方法对64例肢体离断伤软组织缺损的创面处理分别采用VSD技术(VSD组,32例)和常规换药治疗(对照组,32例);观察和比较二者疗效。结果VSD组创面清洁时间为5～1(2平均8.4)d;2例二期缝合加植皮,29例植皮,1例皮瓣转位。对照组创面清洁时间为为10～3(9平均22.6)d;25例植皮,7例皮瓣转位。2组创面清洁时间差异有显著性(<0.01)。结论VSD对肢体离断伤软组织缺损创面的处理较传统换药有更好的效果。Objective To investigate the effect of vacuum sealing drainage （VSD） technique on the management of open skin and soft tissue defects during emergency replantation of limbs. ;Methods Thirty-two cases with open skin and soft tissue dirty defects during and after replantation of limbs were treated by the VSD technique （negative pressure of 50 to 60 kPa） after 5-7days and were managed by traditional method as control group. Results After 5-7days of the application of vacuum sealing drainage （VSD） technique, the limbs survived and healed well, all wound surface also healed completely, thus decreased infection rate and stimulated the proliferation of granulation tissue. No complications （systemic and local） were found, and wound closure was performed with secondary suturing, or free flap, or loco-regional flap and mesh-grafts after 5 to 7 days. Compared with the traditional method of dressing wound, there was significant difference in time of treatment, total cost of treatment and complication rate between 2 groups （P 〈 0.01）.Conclusion Compared with the traditional method of dressing wound, a combination of VSD procedure during emergency replantation of limbs is a simple and effective method in the treatment of open soft tissue dirty defect injuries during mutilation of limbs.

关 键 词：封闭式负压引流 软组织缺损 

分 类 号：R658[医药卫生—外科学]