VSD技术在四肢皮肤软组织撕脱伤治疗中应用效果  

EFFECT OF VACUUM SEALING DRAINAGE IN TREATMENT OF SKIN AND SOFT TISSUE AVULSION OF THE EXTREMITIES

作　　者：闫浩[1] 谢凌寒[1] 童梁成 

机构地区：[1]中国人民解放军第四五四医院骨科,江苏南京210002

出　　处：《齐鲁医学杂志》2017年第3期345-347,共3页Medical Journal of Qilu

摘　　要：目的探讨封闭式负压吸引(VSD)技术在四肢撕脱皮肤软组织回植手术中的应用效果。方法收集2012年1月—2014年12月因四肢皮肤软组织撕脱伤收住院的病人192例,病人均进行清创、皮肤软组织回植,87例(A组)行单纯加压包扎,105例(B组)以VSD技术处理。比较两组病人的皮肤软组织成活情况、治疗周期、术后72h疼痛评分、感染率以及二次手术率。结果 B组病人皮肤软组织成活情况明显优于A组(Z=8.146,P<0.01)。A、B组病人平均住院时间分别为(23.1±3.1)、(12.4±2.3)d,术后72h疼痛评分分别为(8.32±1.05)、(1.78±0.67)分,感染率分别为47.1%和12.4%,二次手术率分别为44.8%和18.1%,B组以上指标均明显优于A组(t=6.121、5.332,χ2=5.691、5.729,P<0.05)。结论相对于单纯的加压包扎方式,在四肢撕脱皮肤软组织回植手术中应用VSD技术可缩短治疗周期,缓解病人疼痛,降低二次手术率,减轻医护人员负担。Objective To investigate the effect of vacuum sealing drainage（VSD）in the replantation of the avulsed skin and soft tissue of the extremities. Methods A retrospective study was performed in 192 patients with skin and soft tissue avulsion of the extremities who were hospitalized in our hospital from January 2012 to December 2014.All patients underwent debridement and replantation of skin and soft tissue,and then 87patients（group A）received simple pressure dressing,while 105patients（group B）received VSD.The following indices were compared between the two groups：survival rate of skin and soft tissue,treatment duration,and pain score,infection rate,and reoperation rate at 72 hafter surgery. Results Compared with group A,group B had a significantly higher survival rate of skin and soft tissue（Z=8.146,P〈0.01）and a significantly shorter hospital stay（（12.4±2.3）d vs（23.1±3.1）d,t=6.121,P〈0.05）.And group B had significantly lower pain score,infection rate,and reoperation rate at 72 hours after surgery than group A（1.78±0.67 vs 8.32±1.05,t=5.332,P〈0.05;12.4% vs 47.1%,χ2=5.691,P〈0.05;18.1% vs 44.8%,χ2=5.729,P〈0.05）. Conclusion In the replantation of the avulsed skin and soft tissue of the extremities,compared with simple pressure dressing,VSD can shorten the treatment duration,relieve patients’ pain,and reduce the reoperation rate and the burden of medical staff.

关 键 词：负压伤口疗法 四肢 软组织损伤 治疗结果 

分 类 号：R641[医药卫生—外科学] R615[医药卫生—临床医学]