改良的封闭式负压引流术在体表慢性溃疡中的临床应用研究  

Study on treatment of chronic skin ulcer wound with modified vacuum-assisted closure

作　　者：朱郇荣[1] 王维平[2] 姬忠良[2] 彭佳华[2] 

机构地区：[1]广州市第八人民医院普外科,510060 [2]中山大学附属第一医院急诊科,510080

出　　处：《新医学》2010年第4期231-233,共3页Journal of New Medicine

摘　　要：目的:探讨改良的封闭式负压引流术(VAC)治疗体表慢性溃疡创面的疗效。方法:采用改良的VAC治疗321例体表慢性溃疡患者,严格清创,根据创面的情况修剪医用海绵,将带侧孔的引流管插入海绵,用海绵敷料填塞创面,再用手术薄膜封闭敷料和创面,最后连接负压引流瓶及负压源(采用20kPa的负压),使负压作用于创面,连续予负压封闭治疗24～72h后更换敷料1次,创面长出新鲜肉芽后进行植皮手术或直接缝合作为临床观察终点,分析疗效。结果:321例患者显效320例(99.6%),有效1例(0.4%)。321例经手术后创面全部愈合。其中压力性溃疡新鲜肉芽形成所需时间为30～96d,中位时间45d,无任何不良反应和并发症。结论:改良VAC治疗体表慢性溃疡疗效较好。Objective：To study the clinical effect of modified vacuum-assisted closure in treatment of chronic skin ulcer wound.Methods：Three hundred and twenty-one cases of skin ulcer wound were treated with modified vacuum-assisted closure（VAC）.After thorough debridement,we covered the wound with appropriate size of foam dressing which drainage catheter was implanted,then sealed the wound with the adhesive transparent membrane.The distal end of the drain was connected to the drainage vessel which a controlled sub-atmospheric pressure was applied（typically 20 kPa below ambient pressure）.The dressing was changed every 24 to 72 hours until enough granulation tissue has grown for suture or skin grafting.Results：After VAC treatment,321 cases undergone suture or skin grafting without complications.This treatment exhibited marked healing effect in 320 cases of total 321 cases,and moderate effect in the other case.30~96 d were needed for granulation tissue to grow from ulcer wound under pressure,with the median of 45 d.Conclusion：The modified VAC system is an alternative treatment for chronic skin ulcer wound.

关 键 词：封闭式负压引流术 慢性溃疡 体表 

分 类 号：R632.1[医药卫生—外科学]