手部感染创面植皮后VSD治疗的临床疗效分析  

Analysis of curative effect of VSD after skin graft in infected hand wound

作　　者：刘恒鑫[1] 宋保强[1] 陈建武[1] 张兆祥[1] 孙峰[1] 张娟[1] 

机构地区：[1]第四军医大学西京医院整形外科,陕西西安710032

出　　处：《中国美容整形外科杂志》2015年第5期297-301,共5页Chinese Journal of Aesthetic and Plastic Surgery

摘　　要：目的 探讨断层皮片移植结合负压封闭引流技术（VSD）治疗手部感染创面的临床效果.方法 自2012年8月至2013年6月,共80例手部感染创面患者接受断层皮片移植.根据患者的经济条件及个人意愿,其中44例于植皮后行VSD治疗（VSD组）,36例植皮后行传统打包固定（打包组）;术前比较两组患者的基本情况及围手术期应用抗生素情况均无明显差异.术后12h时记录患者的植皮区域疼痛情况;7 d后观察两组皮片成活面积,视情况给予换药及补充植皮等处理.结果 VSD组在术后疼痛情况、皮片成活面积、植皮区感染例数、二次补充植皮率等方面明显优于打包组,其差异均有统计学意义（P＜0.05）.结论 断层皮片移植结合VSD,可有效治疗手部感染创面,并提高了植皮成活率,值得推广应用.Objective To investigate the clinical effect of split-thickness skin graft with VSD on infected hand wounds. Methods From August 2012 to June 2013, 80 patients with infected hand wounds accepted split-thickness skin grafts and VSD （vacuum sealing drainage）. According to their economic conditions and personal willingness, 44 of 80 patients （the VSD group） were treated with the split-thickness skin grafts and VSD, the other 36 patients （the package group） received traditional package fixation after skin grafts. No sig- nificant difference was noted in the general situation of preoperative patients and the perioperative application of antibiotics between two groups. The level of pain in the grafted area was assessed at 12 hours postoperatively, and also the skin survival area was recorded after removing dressing or VSD at 7 days. According to the situa- tion of wound healing, either dressing change or secondary skin graft was applied to restore the remaining de- fects area. Results Compared with the package group, the VSD group lowered the lever of pain, promoted the survival of skin graft, reduced the number of infection and decreased the rate of secondary skin graft （ P 〈0. 05）. Conclusion Split-thickness skin graft with VSD, promoting the survival of skin graft, is a good alter- native for infected hand wound and is worth to be popularized in clinical.

关 键 词：断层皮片移植 负压封闭引流技术 手部感染创面 

分 类 号：R622[医药卫生—整形外科]