负压封闭引流技术联合外固定支架在治疗下肢毁损伤中的应用  

Clinical Application of Vacuum Sealing Drainage Combining with External Fixation Stents in the Treatment of Lower Limb Destroyed Damage

作　　者：刘伟[1] 郑佐勇[1] 区广鹏[1] 肖军[1] 李贝[1] 欧丽珍[1] 黄瑞良[1] 艾合买提江.玉素甫[2] 

机构地区：[1]广东医学院附属高明医院骨二科,广东省佛山市528500 [2]新疆医科大学第一附属医院骨科中心,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《组织工程与重建外科杂志》2012年第4期204-207,共4页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：佛山市医学类科技攻关项目(201108288)

摘　　要：目的探讨负压封闭引流技术（VSD）联合外固定支架治疗下肢毁损伤的疗效。方法2007年10月至2011年11月,采用VSD结合外固定支架治疗22例下肢毁损伤患者。所有患者均行急诊清创、骨折复位后外固定支架固定,采用具有正向冲洗功能的VSD护创材料封闭创面,待创面洁净、肉芽生长后,采用植皮或邻近带血管蒂皮瓣转移二期修复创面。结果所有患者经VSD治疗7~21 d（平均13 d）后,关闭创面。22例患者术后随访12~24个月,术后发生感染3例（13.6%）,经换药及抗生素治疗后痊愈;骨折愈合时间为4~12个月（平均6.5个月）。结论VSD结合外固定支架能迅速有效地稳定骨折,早期闭合创面,促进骨折愈合,减少并发症的发生,是下肢毁损伤的理想治疗方法。Objective To explore the effect of the vacuum sealing drainage （VSD） combining with external fixation stents in the treatment of lower limb destroyed damage. Methods From October 2007 to November 2011, the VSD combining with external fixation stents was used in 22 patients with lower limb destroyed damage. All the patients were performed emergency debridement, open reduction, external fixation, and the wounds were covered by VSD materials with positive washing function. The repair of the wounds of second stage was performed by skin grafts or vascular pedicle flap when the wounds were clean and granulation growth was observed. Results Twenty-two patients were followed up for 12 to 24 months. All wounds were closed after VSD treatment for 7 to 21 days （average 13 days）. Infection was occurred in $ cases （13.6%）, and was healed by daily dressing and antibiotic treatment. The fracture healing time was 4 to 12 months （mean 6.5 months）. Conclusion The VSD combining with external fixation stents could stabilize the fracture effectively, early close the wounds, promote the fracture healing, reduce complications, and is a good choice for the treatment of lower limb destroyed damage.

关 键 词：毁损伤 外固定架 负压封闭引流术 

分 类 号：R641[医药卫生—外科学]