网状游离植皮联合负压封闭引流技术在糖尿病足创面修复中的应用  

The clinical application of mesh free skin graft combined with vacuum sealing drainage for diabetic foot wound healing

作　　者：李明飞[1] 顾洪斌[1] 王志鸿[1] 杨帆[1] 解华杰 盛磊[1] 孙晓风[1] 

机构地区：[1]解放军306医院血管外科,北京100101

出　　处：《中国医刊》2018年第2期175-178,共4页Chinese Journal of Medicine

摘　　要：目的观察网状游离植皮联合负压封闭引流(vaccum sealing drainage,VSD)技术在糖尿病足创面修复中的临床疗效。方法选择2013年5月至2016年4月解放军306医院血管外科收治的重度感染性糖尿病足患者32例,足部创面经清创治疗、控制感染、被覆新鲜肉芽后,行网状游离植皮联合负VSD技术修复创面,观察治疗结果。结果 32例患者中,24例因合并重症肢体缺血接受下肢动脉腔内治疗以改善血供,8例为单纯深部组织感染,行切开清创引流以控制全身感染。32例患者植皮术前平均接受清创术的次数为(3±1)次,植皮后平均创面愈合时间为(20±7)天,植皮手术成功率为100%,其中25例皮片成活面积大于95%,7例皮片成活面积约80%。供皮区创面平均愈合时间(19±6)天。结论网状游离植皮术联合VSD技术可促进糖尿病足创面愈合,提高移植皮片成活率,明显缩短创面修复时间,且该技术简单可靠,值得临床推广。Objective To explore the clinical efficacy of mesh free skin graft combined with vacuum sealing drainage（VSD） for diabetic foot wound healing. Method Total 32 patients with severe infection diabetic foot were involved in this research between May 2013 and June 2016. After debridements, the infections were controlled and the wounds were covered by fresh granulation, patients underwent mesh free skin grafting combined with VSD negative pressure technique for wounds repair. Result In 32 patients, 24 patients complicated with critical limb ischemia received endovascular treatment to improve blood supply; the other 8 patients were pure infection so that had been incision and drainage. Each patient received debridement for 3±1 times before Skin grafting. After skin grafting, the mean wound healing time was 20±7 days. The success rate of skin grafting was 100%, of which 25 cases of skin graft survival area was more than 95%, and 7 cases of skin graft survival area was about 80%. In the donor site, the mean wound healing time was 19±6 days. Conclusion Mesh free skin grafting combined with vacuum sealing drainage technique can be used for diabetic foot repair. This technology is simple, reliable and easy to spread. Vacuum sealing drainage technology during skin grafting can promote diabetic foot wound granulation growth, improve the survival rate of skin graft, and shorten the time of wound healing.

关 键 词：糖尿病足 网状植皮术 负压封闭引流技术 修复与重建 

分 类 号：R587.2[医药卫生—内分泌]