伤口内负压引流装置在手外科手术引流中的应用  

Application of negative pressure drainage device in wounds of hand surgical drainage

作　　者：林慧鑫 周望高 张振伟 旷玲玉 李东扬 谭亚茜 LIN Huixin;ZHOU Wanggao;ZHANG Zhenwei(Department of Hand Surgery,Shajing People's Hospital,Guangzhou Medical University,Shenzhen,Guangdong,518104,China)

机构地区：[1]广州医科大学附属深圳沙井医院手外科,广东深圳518104

出　　处：《实用手外科杂志》2020年第3期266-268,共3页Journal of Practical Hand Surgery

基　　金：深圳市宝安区科技创新局科研项目(编号:2016CX135);实用新型专利(专利号:ZL 2016 2 1112144.7).

摘　　要：目的探讨伤口内负压引流装置在手外科手术引流中的临床应用效果。方法回顾性分析2015年1月-2019年6月采用自行设计的负压引流装置应用于手外科手术引流的122例患者临床资料。记录术后伤口引流量、引流管拔管时间、观察伤口愈合及感染情况、撕脱伤皮肤及皮瓣成活情况、术后随访皮肤瘢痕增生及手功能情况。结果122例伤口平均引流量为23 mL,引流管拔除时间2~5 d,平均3.8 d,伤口均甲类愈合,无一例出现伤口感染,手掌皮肤逆行撕脱伤及手掌严重压砸伤患者手掌皮肤成活良好,移植皮瓣全部成活。术后随访6~18个月,平均10.2个月,伤口瘢痕增生不明显,色素沉积不明显。按中华医学会手功能评定标准中掌指关节和指间关节伸屈功能总主动活动度:优109例,良10例,中3例,优良率为97.5%。结论伤口内负压引流装置应用于手外科手术引流充分,能有效预防伤口感染,减少肌腱粘连,减少瘢痕增生,治疗效果良好,操作简单,是一种理想的手外科手术的引流方式。Objective To explore the clinical application effect of negative pressure drainage device in the drainage of hand surgery.Methods Retrospective analysis of the negative pressure drainage device designed by ourselves from January 2015 to June 2019 was applied in 122 patients with hand surgery drainage.The postoperative wound drainage,drainage tube extubation time,observation of wound healing and infection,avulsed skin and flap survival were recorded.The skin scar hyperplasia and hand function were followed up.Results The average drainage volume of the wounds in the 122 patients was23 ml,the extraction time of the drainage tube was 2 to 5 days,and the average was 3.8 days.All the wounds healed,no wound infection occurred,the palm skin survived in the casees of the retrograde avulsion of the palm skin and the severe palm skin crush injury,all the transplanted flaps survived.The patients were followed up for 6 months to 18 months,with an average of 10.2 months.The scar hyperplasia of the wound was not obvious,and the pigmentation was not obvious.According to the Chinese Medical Association hand function evaluation standard,the total active activity of the metacarpophalangeal joint and interphalangeal joint flexion and extension function:excellent in 109 cases,good in 10 cases,and in 3 cases,the excellent and good rate was 97.5%.Conclusion The negative pressure drainage device in the wound is suitable for hand surgical drainage,which can effectively prevent wound infection,reduce tendon adhesion,reduce scar hyperplasia,and has good therapeutic effect and simple operation.It is an ideal drainage method for hand surgery.

关 键 词：手外科 手术 伤口引流 伤口愈合 肌腱粘连 

分 类 号：R658.2[医药卫生—外科学]