封闭负压引流结合持续冲洗治疗四肢创面软组织缺损  

The use of vacuum sealing drainage combined with continuous irrigation to treat traumatic soft tissue defect

作　　者：龚翔[1] 杨杰[1] 彭吾训[1] 

机构地区：[1]贵阳医学院附属医院急诊创伤外科,贵州贵阳550004

出　　处：《临床骨科杂志》2014年第2期207-210,共4页Journal of Clinical Orthopaedics

摘　　要：目的探讨封闭负压引流(VSD)结合持续冲洗技术治疗四肢软组织缺损创面的临床效果。方法对56例四肢软组织缺损患者采用VSD结合持续冲洗方法治疗28例(VSD组)、传统换药方式治疗28例(传统组),比较两组创面植皮前缩小面积、清创后距植皮时间、植皮后治疗时间、植皮后换药次数。结果 VSD组治疗后均未出现发热,创面均无明显脓性分泌物。创面植皮前缩小面积:VSD组为(4.35±1.27)cm2,传统组为(2.24±0.68)cm2。清创后距植皮时间:VSD组为(11.82±2.37)d,传统组为(16.07±2.58)d。植皮后治疗时间:VSD组为(13.93±3.80)d,传统组为(19.00±4.75)d。植皮后换药次数:VSD组为(4.86±1.53)次,传统组为(8.39±1.59)次。两组创面植皮前缩小面积比较差异无统计学意义(P>0.05),其余比较差异均有统计学意义(P<0.01)。结论 VSD结合持续冲洗可有效控制创面感染,促进创面愈合,降低换药次数,缩短治疗时间,有利于创面修复及移植皮片的存活。Objective To evaluate the clinical curative effect of vacuum sealing drainage （VSD） combined with con- tinuous irrigation in the soft tissue defects of limbs. Methods Using VSD combined continuous irrigation in 28 cases of skin defects （ VSD group） and traditional way in 28 cases （ traditional group） to compare the narrow area of wound before skin grafting, treatment time between debridement and skin grafting, treatment time after skin grafting, number of dressing after skin grafting in 2 groups. Results 28 patients in VSD group didn＇t appear fever and obviously puru- lent were not found. The treatment effect of VSD group was better than traditional group in some aspects-the narrow area of the wound before skin grafting were （4. 35 ± 1.27） cm2 in the VSD group and （2. 24 ± 0. 68 ） cm2 in the tra- ditional group, treatment time between debridement and skin grafting were （ 11.82 ± 2. 37） d in the VSD group and （16. 07 ±2. 58） d in the traditional group , treatment time after skin grafting were （13.93 ±3.80） d in the VSD group and （ 19.00 ±4. 75） d in the traditional group, treatment time after skin grafting were （4. 86 ± 1.53 ） times in the VSD group and （8. 39 ±1.59） times in the traditional group. The difference of narrow area of the wound before skin grafting showed no statistically significant（P 〉 0. 05 ）. The remaining difference was statistically significant （ P 〈 0. 01）. Conclusions VSD combined with continuous irrigation can effectively decrease the rate of wound infection, promote wound healing and reduce the number of dressing changes, shorten treatment time. And it is conducive to wound healing and skin flap survival.

关 键 词：封闭负压引流 持续冲洗 软组织缺损 四肢损伤 皮肤移植 

分 类 号：R658[医药卫生—外科学] R622.12[医药卫生—临床医学]