负压封闭引流技术在 Gustilo-AndersonⅡ～Ⅲ型开放骨折中的应用  

The vacuum sealing drainage in Gustilo-AndersonⅡ~Ⅲtype open fractures treatment

作　　者：杜中兴 岳发翔 朱贤久 唐方科 

机构地区：[1]郧县人民医院创伤显微骨科,湖北郧县442500

出　　处：《临床骨科杂志》2014年第2期210-212,共3页Journal of Clinical Orthopaedics

摘　　要：目的：探讨负压封闭引流技术（VSD）在Gustilo-AndersonⅡ～Ⅲ型开放骨折治疗中的作用。方法对25例Gustilo-AndersonⅡ～Ⅲ型开放骨折患者的断端软组织缺损一期无法缝合的骨外露创面行VSD治疗，术后冲洗引流，二期植皮或皮瓣、复合组织瓣修复。结果13例一期清创用VSD治疗，二期植皮或皮瓣修复；10例经再次或多次行VSD治疗，创面新鲜后植皮或皮瓣、复合组织瓣修复。2例感染，经换药、引流，抗感染治疗，延期行复合骨瓣修复创面痊愈。创面愈合时间18～56（35＆#177;11）d。25例均获随访，时间10～24（18＆#177;6）个月，骨折均达临床愈合。无创伤性骨髓炎发生。结论对于Gustilo-AndersonⅡ～Ⅲ型开放骨折皮肤软组织缺损较重患者行VSD治疗，可为二期修复创造了良好的条件。Objective To study the effect of vacuum sealing drainage （VSD）in Gustilo-Anderson Ⅱ~Ⅲ type open fractures.Methods 25 cases of Gustilo-AndersonⅡ~Ⅲtype open fractures with soft tissue defect issue were trea-ted with VSD technology,postoperative irrigation drainage,secondary skin graft or skin flap,compound tissue flap to repair.Results 13 cases got the second phase of skin graft or skin flap to repair,10 cases by the line once again or many times the VSD to cover the wound,the wound after fresh skin graft or skin flap,compound tissue flap to repair. 2 cases got infection,after debridement,drainage,and anti-infection treatment,delay line composite bone flap was used to repair the wound healing.The wounds headed in 18 ~56 （35 ＆#177;11）months,25 cases were followed up for 10~24（18 ＆#177;6）months.All got fracture union.No traumatic osteomyelitis was found.Conclusions For Gustilo-An-derson Ⅱ~Ⅲ type open fractures,patients with more serious skin and soft tissue defect,the VSD to cover the wound,can provide ideal result.

关 键 词：负压封闭引流技术 开放骨折 外科皮瓣 皮肤移植 

分 类 号：R683.4[医药卫生—骨科学] R687.3[医药卫生—外科学]