负压封闭技术在下肢大面积皮肤撕脱伤的治疗探析  

Treatment of large avulsion injury of skin of lower limbs by reattachment of skin combined with vacuum sealing drainage

作　　者：黄思贵[1] 刘春[1] 钟吉华 

机构地区：[1]四川省内江市第二人民医院烧伤整形科,内江641000

出　　处：《重庆医科大学学报》2009年第1期122-124,共3页Journal of Chongqing Medical University

摘　　要：目的:探讨负压封闭引流技术(Vacaum staling drainage,VSD)治疗下肢大面积皮肤撕脱伤的临床效果。方法:对近3年来我院收治的下肢大面积皮肤撕脱伤患者44例采用筛孔状全厚皮片移植法修复,皮片表面用多聚乙烯醇明胶海绵材料(商品名"维克伤")覆盖封闭,24h不间断负压吸引(维持负压在-40～-60kPa之间)。结果:平均使用VSD7d,39例皮片全部存活创面愈合,5例皮片存活95%～98%,经换药后,创面愈合,患肢运动功能及外观恢复良好。与对照组比较,在平均住院天数、植皮的愈合率、换药次数及总费用等方面差异均有统计学意义(P<0.05)。结论:筛孔状全厚皮片移植法原位修复结合VSD处理下肢皮肤撕脱创面能在Ⅰ期关闭创面的同时更好地进行创面引流,降低感染地发生,促进创面地良好贴附,有利于皮片存活,是治疗下肢皮肤撕脱伤较好地处理方法。Objective： To investigat the treatment effects of reattachment of skin combined with vacuum sealing drainage （VSD） on large avulsion injury of skin of lower limb. Metbods：44 cases of treated by reattachment of with sieve-pore full-thickness skingrafts, the wound surface was filled with polyvinyl alcohol foams （vacuscal） continuous negative pressure drainage was taken for 2dh.Result：The average tim of VSD was 7 days.39 cases recovered completely.The flap survival rate in 5 cases was reattaching sieve-pore full-thickness skin grafts combined with VSD,which is a crediable treatment of limbs skin-tear wound. Conclusion ：The large avulsion injury of skin of lower limbs could be closed by reattaching sieve-pore full-thickness skin grafts combined with VSD,which is a crediable treatment of limbs skin-ter wond.

关 键 词：负压封闭引流技术 原位植皮术 下肢皮肤撕脱伤 

分 类 号：R641[医药卫生—外科学]