负压封闭引流联合竖脊肌肌瓣修复脊柱内固定术后深部感染创面的临床应用  

Clinical application of vacuum sealing drainage combined with erector spinalis muscle flap in repairing deep infected wounds after spinal internal fixation

作　　者：计鹏 陶克 张智 曹涛 佟琳 王璟 韩超 胡大海 JI Peng;TAO Ke;ZHANG Zhi;CAO Tao;TONG Lin;WANG Jing;HAN Chao;HU Dahai(Burns Center of PLA,Department of Burns and Cutaneous Surgery,Xijing Hospital,Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学西京医院烧伤与皮肤外科,全军烧伤中心,陕西西安710032

出　　处：《空军军医大学学报》2022年第3期305-308,共4页Journal of Air Force Medical University

基　　金：国家自然科学基金面上项目(81871561);空军军医大学西京医院学科助推项目(2020XJZT19Z03)。

摘　　要：目的探讨应用创面负压封闭引流(VSD)技术联合竖脊肌肌瓣修复脊柱内固定术后深部感染创面的临床效果。方法2016年1月至2020年12月采用VSD联合竖脊肌肌瓣治疗脊柱内固定术后深部感染创面的患者15(男11,女4)例;年龄22~78(平均49.7)岁。所有患者均接受沿原手术切口切开、彻底扩创冲洗,术中保留内固定,术后采用VSD联合竖脊肌肌瓣转移的治疗方式。结果14例患者术后切口均Ⅰ期愈合,1例患者术后切口愈合不良,经4次换药,2周后愈合。随访3~18个月,所有患者切口愈合良好,无复发。结论应用VSD联合竖脊肌肌瓣转移的方法可有效修复脊柱内固定术后深部感染创面,明显缩短疗程,术后复发率低,是治疗此类患者的有效治疗方式。Objective To investigate the clinical effect of vacuum sealing drainage(VSD)combined with erector spinalis muscle flap in the repair of deep infected wounds after spinal internal fixation.Methods From January 2016 to December 2020,15 patients including 11 males and 4 females with deep infected wounds after spinal internal fixation were t reated with VSD combined with erector spinalis muscle flap.The patient age ranged from 22 to 78 years old,with an average of 49.7 years old.All of the patients were treated with incision along the original operation incision,thorough wound expansion and flushing,and intraoperative internal fixation,and VSD combined with erector spinalis spinal muscle flap transfer was used after the operation.Results The incisions of 14 patients healed in the first stage,and 1 patient s wound showed poor healing.After 4 dressing changes,the patient s wound healed 2 weeks after operation.The patients were followed up for 318 months after operation.The incisions healed well and there was no recurrence in patients.Conclusion VSD combined with erector spinalis muscle flap transfer can effectively repair deep infected wounds after spinal internal fixation,significantly shorten the course of treatment and reduce the postoperative recurrence rate.It is an effective therapeutic method for this kind of patients.

关 键 词：负压封闭引流 手术部位感染 脊柱 内固定 

分 类 号：R641[医药卫生—外科学]