负压封闭引流在车祸伤四肢皮肤缺损中的临床应用  

Study on Clinical Application of VSD in the Treatment of Skin Defect of Extremities Caused by Traffic Accidents

作　　者：丁宝志[1] 黎晓华[1] 庄蕾[1] 王惠东[1] 陈铿[1] 

机构地区：[1]上海交通大学医学院附属第三人民医院骨科,上海201900

出　　处：《医学临床研究》2013年第1期13-15,共3页Journal of Clinical Research

基　　金：上海市申康医院发展中心适宜技术联合开发推广项目（SHDC12010203）

摘　　要：【目的】研究封闭负压引流（VSD）技术在车祸外伤致四肢创面污染或感染修复治疗中的临床疗效。【方法】本院收治的16例车祸外伤后四肢皮肤软组织缺损伴严重污染或感染患者。其中男10例，女6例，上肢2例，下肢14例。受伤至手术时间：〈6h者7例，平均4．2h，6～12h者3例，平均7．8h；〉24h者6例，平均22．8d。创面面积15cm×4cm～80cm×20cm。所有病例均彻底清创后覆盖VSD6～10d，1～4次。7例皮瓣修复，6例植皮，3例皮肤脱套伤者予以皮肤修薄后原位回植。【结果】13例创面均无感染，肉芽生长良好，修复术后移植皮片及皮瓣一期愈合；3倒原位回植皮肤全部成活。【结论lvsD有非常良好的控制污染创面感染的作用，可促进肉芽生长，为深部组织修复重建及创面的修复打下良好的基础，其临床优良的效果具有推广价值。[Objective]To explore the clinical efficacy of continuous vacuum sealing dressing（VSD） in the treat- ment of polluted or infected wounds of extremities caused by traffic accidents. [Methods]Sixteen patients with serious polluted or infected skin and soft tissue defect of extremities caused by traffic accidents were treated in our hospital. All patients included 10 men and 6 women. Among all patients, 6 patients were the defect of upper extremities and 14 patients were the defect of lower extremities. The time of injury to operation of 7 patients was less than 6h（mean 4.2 h）, and that of 3 patients was 6~12h（mean 7.8h）, and that of 6 patients was more than 24 h（mean 22.8d）. The area of wounds was from 15 crux 4cm to 80cm）〈 20cm. All the patients were treated with VSD after thorough debrid- ment for 6~10d and 1~4 times. Seven patients underwent skin flap operation, and 3 patients underwent dermato- plasty, and 3 patients with degloving skin injury underwent skin orthotopic transplantation after skin thickening, iRe- suits]The wounds of 13 patients had no infection, and the granulation grew well, and the free skin grafts and flaps were healed for one stage after repair surgery. The orthotopic transplanted skin of the other 3 patients was all surviv- al. [Conclusion] VSD has good effect on controlling polluted and infected wounds , and can promote the growth of granulation, and creates the good foundation for the reconstruction of deep tissue and wound repair. Its efficacy is worthy of clinical generalization.

关 键 词：皮肤 损伤 四肢 

分 类 号：R64[医药卫生—外科学]