负压封闭引流技术在小腿毁损伤中的应用  

Vacuum sealing drainage technique to save the calf injury from Collins-Temple Ⅰ to Ⅳ application

作　　者：刘伟[1] 郑佐勇[1] 熊浩[1] 林伟文[1] 夏雄超[1] 赖茂松[1] 区广鹏[1] 黄瑞良[1] 

机构地区：[1]广东省佛山市高明区人民医院骨一科,528500

出　　处：《疑难病杂志》2013年第6期431-433,F0003,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：佛山市医学类科技攻关项目(No.201108288)

摘　　要：目的探讨封闭负压引流(VSD)技术在挽救小腿毁损伤治疗中的应用效果。方法选择2008年1月—2012年8月小腿毁损伤患者27例,对所有患者小腿毁损伤进行清创、骨折外固定术后进行VSD治疗,压力维持-60～-40 kPa。受伤至入院时间为4～10 h,中位数6 h。小腿损伤程度采用四肢损伤分级标准评分,平均10.0分。采用VSD治疗后保肢成功,其中术后24例游离植皮修复,3例采用健侧腓肠神经营养血管蒂皮瓣修复,供区游离植皮修复。结果患肢彻底清创后VSD治疗2～3次,肉芽组织采用植皮及皮瓣覆盖创面均顺利成活,创面均Ⅰ期愈合,供区切口Ⅰ期愈合。患者均获随访,时间12～24个月,中位数18个月。植皮创面均愈合良好,未出现窦道、感染。皮瓣色泽正常,无臃肿。X线摄片检查示骨折均愈合,时间3～12个月。结论 VSD技术可挽救小腿毁损伤截肢以及减小创面感染的几率,促进创面肉芽组织生长,为植皮及皮瓣移位修复提供良好的条件。Objective To investigate sealing negative pressure drainage （VSD） the technical saving calf damages in the wound early time treatment application effect. Methods From January,2008 to January , 2010 , damages the wound crea- tes, outside clear the bone fracture the pexia the VSD treatment after 27 example patient calf, pressure maintenance - 60 - - 40 kPa. Is injured to in hospital time is 4 - 10 h, average 6 h. The calf extent of damage uses four extremity damage grading standards grading average 10.0 points. After using the VSD treatment, guarantees the extremity to be successful, 24 example dissociation skin grafting repair, 3 examples use the healthy side sural nerve vasa vasorum tippy petal repair, for area dissocia- tion skin grafting repair. Results After contracting the extremity thorough creates clear, VSD to treat 2 - 3 times, the granu- lation tissue covers the injured area to give the skin grafting and flap survives smoothly, the injured area is I grade heals, for area marg/n I grade heals. The patient attains the revisit, the revisit time 12 -24 months, the average 18 months. The skin grafting injured area heals good, has not presented sinus, the infection. The skin petal luster is normal, is not extremely fat. X ray film inspection shows the bone fracture to heal, heal time is 8 - 12 months. Conclusion The VSD technology may save the calf to damage the wound amputation as well as the injured area infection probability, promotes the injured area granulation tissue to grow, provides the good condition for the skin grafting and the skin petal shifting repair.

关 键 词：封闭负压引流 毁损伤 创面修复 

分 类 号：R658.3[医药卫生—外科学]