波动式负压引流技术在穿支皮瓣移植修复难愈性创面中的应用  

Application of Undulant vacuum Sealing Drainage in Patients with Refractory Wounds Undergoing Perforator Flap Transplant Repair

作　　者：周晓春[1] 陈晓明 王惠[3] 芮睿 徐旭 ZHOU Xiaochun;CHEN Xiaoming;WANG Hui;RUI Rui;XU Xu(Department of Burns and Plastic Surgery,Affi liated Hospital of Nantong University,Liyang People's Hospital,Liyang 213300,Jiangsu,China;Department of Plastic Surgery and Burn,the Second Affi liated Hospital of Chengdu Medical College,Nuclear Industry 416 Hospital,Chengdu 610000,Sichuan,China;Department of Plastic Surgery,The Second Affi liated Hospital of Soochow University,Suzhou 215000,Jiangsu,China)

机构地区：[1]溧阳市人民医院南通大学附属溧阳医院烧伤整形科,江苏溧阳213300 [2]成都医学院第二附属医院核工业四一六医院整形烧伤科,四川成都610000 [3]苏州大学附属第二医院整形美容外科,江苏苏州215000

出　　处：《中国美容医学》2022年第2期21-25,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析波动式负压封闭引流(VSD)技术在穿支皮瓣移植修复难愈性创面患者中的应用效果。方法:将2017年1月-2020年4月在笔者医院接受诊治的60例难愈性创面患者按随机数字表法分观察组与对照组,每组30例。对照组清创术毕后常规放置引流条,无菌辅料包扎并定期换药,观察组接受VSD干预,两组肉芽组织生长满意后均行穿支皮瓣移植修复。比较两组炎症指标、细菌清除率、肉芽组织覆盖率、创面愈合时间、首次清创距离手术时间、换药次数、住院时间及首次清创后3 d、7 d、11 d时的视觉模拟评分(VAS)评分,统计两组创面愈合率。结果:治疗7 d后,两组白细胞计数(WBC)、C-反应蛋白(CRP)、血沉(ESR)较治疗前均明显下降,观察组WBC、CRP、ESR水平低于对照组,差异有统计学意义(P<0.05)。观察组细菌清除率及肉芽组织覆盖率高于对照组,创面愈合时间、首次清创距离手术时间、住院时间较对照组短,换药次数较对照组少(P<0.05)。观察组首次清创后3 d、7 d、11 d时的VAS评分显著低于对照组(P<0.05)。观察组创面愈合率高于对照组(P<0.05)。结论:较常规干预,VSD技术用于穿支皮瓣移植修复难愈性创面患者于创面愈合有益,值得临床推介。Objective To analyze the application effect of undulant vacuum sealing drainage (VSD) in patients with refractory wounds undergoing perforator flap transplant repair.Methods Sixty patients with refractory wounds were treated in the hospital between January 2017 and April 2020.They were divided into observation group and control group by random number table method,30 cases in each group.The control group was treated with drainage strips,sterile auxiliary materials for wound dressing,and regular dressing change after debridement.The observation group was given VSD.The two groups were treated with perforator flap transplantation when the growth of granulation tissues was satisfactory.The inflammation indexes,bacterial clearance rate,coverage rate of granulation tissues,wound healing time,interval between the first debridement to operation,times of dressing changes,hospitalization time,and scores of visual analogue scale (VAS) at 3d,7d and 11d after the first debridement were compared between the two groups.The wound healing rates in both groups were statistically analyzed.Results After 7 days of treatment,the white blood cell count (WBC),C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in the two groups were significantly lower than those before treatment.The levels of WBC,CRP and ESR in the observation group were lower than those in the control group (P<0.05).The bacterial clearance rate and granulation tissue coverage rate in the observation group were higher than those in the control group.The wound healing time,the first debridement distance,the operation time,the hospital stay were shorter than those in the control group,and the dressing change times were less than those in the control group (P<0.05).The VAS score of the observation group at 3,7 and 11 days after the first debridement was significantly lower than that of the control group (P<0.05).The wound healing rate in the observation group was higher than that in the control group (P<0.05).In control group,and healing rate was higher than

关 键 词：难愈性创面 波动式负压封闭引流技术 穿支皮瓣移植修复 炎症 细菌 创面愈合 

分 类 号：R622.1[医药卫生—整形外科]