改良VSD在下肢严重创伤组织缺损的临床应用  

Clinical Application of Vacuum Sealing Drainage in Treatment of Soft Tissue Defect in Lower Limbs Trauma

作　　者：白力承 贾福[1] 孙瑞芬[2] 

机构地区：[1]昆明医科大学附属延安医院骨科,云南昆明650001 [2]云南中医学院,云南昆明650500

出　　处：《河南科技大学学报（医学版）》2014年第4期259-260,263,共3页Journal of Henan University of Science & Technology:Medical Science

基　　金：云南省教育厅科研基金资助项目(08C0113)

摘　　要：目的采用改良负压封闭引流（VSD）在临床中治疗下肢严重创伤性皮肤软组织创面并探讨其疗效。方法我院在2011年5月至2014年6月共收治58例下肢严重皮肤软组织缺损创面，采用改良VSD技术治疗，辅助生理盐水冲洗7～14d（平均10d）后行皮肤移植或皮瓣修复，47例创面植皮覆盖，11例合并肌腱或骨外露患者行皮瓣移植术。结果本组患者在皮肤移植或皮瓣修复前使用1～4次（平均1．8次）改良VSD治疗创面，36例创面1次手术植皮或皮瓣修复，5例创面2次手术植皮或皮瓣修复，15例因创面大3次手术植皮或皮瓣修复（56例行植皮或皮瓣修复术无1例创面感染发生），仅2例创面皮瓣修复后血供差引起组织坏死需再次手术植皮。结论改良VSD技术能更有效治疗下肢严重创伤创面，明显减轻患者疼痛，减少并发症的发生，有效缩短患者治疗时间，减少手术及住院费用，值得在临床广泛推广。Objective To study the clinical efficacy modified vacuum sealing drainage （VSD）technique for the treatment of extremities skin and soft tissue defect associated with trauma infection. Methods From May 2011 to June 2014, 58 patients with complex lower limbs traumatic defect were admitted to our hospital. Secondary trauma infection occurred in all cases. The defect was applied with VSD and irrigated with physiological saline for 7 to 14 days（ averaging 10days）. 47 cases of wound were covering skin graft, 11 patients with combined tendon or bone exposed skin flap transplantation. Results In this series, 1 to 4 （ averaging, 1.8 ） VSD applications were used before performance of reconstructive surgery, 36 cases of skin graft or skin flap to repair wounds once, 5 cases of skin graft or skin flap to repair wounds 2 times, 15 cases by the three surgical wound skin graft or skin flap to repair, only 2 cases were infected recurrence after trauma healing because of necrotic tissue. Conclusion The modified VSD technique can more effectively cause trauma with complex injury, obviously relieve patients＇ pain, effectively shorten the treatment time, reduce the surgery and hospitalization expenses, reduce the occurrence of complications, and is worth popularizing widely in clinical practice.

关 键 词：改良负压封闭引流 下肢创伤 软组织缺损 皮肤移植 

分 类 号：R641[医药卫生—外科学]