负压封闭引流结合前臂皮瓣移植修复老年前臂及手部深度创面  

Vacuum sealing drainage technology combined with forearm flap transplantation to repair the deep wound of the forearm and hand in elderly patients

作　　者：向锋 沈健[1] 翁志勇 XIANG Feng;SHEN Jian;WENG Zhiyong(Department of Plastic Surgery,Huangshi Central Hospital,Afiliated Hospital of Hubei Polytechnic University,Edong Healcare Group,Hubei,Huangshi 435000,China)

机构地区：[1]湖北省鄂东医疗集团黄石市中心医院(湖北理工学院附属医院)整形外科,435000

出　　处：《临床外科杂志》2022年第8期783-785,共3页Journal of Clinical Surgery

摘　　要：目的 探讨应用负压封闭引流(vacuum sealing drainage, VSD)技术结合前臂皮瓣移植修复老年病人前臂及手部深度创面的临床效果。方法 老年前臂及手部深度创面病人21例,应用VSD技术使得创面清洁新鲜,同时对存在的基础疾病进行治疗;依据创面部位、大小及创面周围软组织条件设计前臂不同类型皮瓣,应用便携式多普勒血流探测仪探查定位皮瓣旋转点,切取皮瓣,修复创面。结果 21例应用VSD技术结合前臂各类皮瓣移植修复老年前臂及手部深度创面均获成功,VSD应用平均时间7天;皮瓣手术时间60~90分钟,平均75分钟;出血量平均约75 ml;术中术后未出现局部血肿、感染、肢体缺血等;所有皮瓣均完全存活;随访结果显示,病人对治疗时程、创面修复外观及患肢功能恢复均表示满意。结论 应用VSD技术结合前臂皮瓣移植修复老年前臂及手部深度创面,皮瓣手术时间短,操作简便快捷,损伤小,手术并发症少,皮瓣修复成功率高,肢体功能可较大限度保存,虽然外观有所欠缺,但对于老年病人安全适用。Objective To explore the clinical effects of applying VSD technology combined with forearm flap transplantation to repair the deep wound on the forearm and hand of elderly patients.Methods There were 21 old people with deep wounds on their forearms and hands.VSD technology was applied to make the wounds clean and fresh, and treatment methods were made to cure underlying diseases simultaneously.Different types of forearm flaps were designed according to the locations of the wounds, sizes of the wounds, and soft tissue conditions around the wounds.Furthermore, portable Doppler blood flow detector was used to locate the rotation points of the flaps, so that the flaps could be cut and wounds could then be repaired.Results 21 cases which used VSD technology combined with various types of forearm flap transplants to repair the elders’ arm and hand deep wound surfaces were successful.VSD application average time was 7 days;the average bleeding volume was about 75 ml;no local hematoma, infection and limb ischemia, etc.occurs after surgery;all the flaps were completely alive;follow-up results showed that the patients were satisfied with the duration and cost of treatment, appearance of the wound repair and recovery of limb function.Conclusion The application of VSD technology combined with forearm flap transplantation to repair the old arm and hand depth wound has some characters: tolerable to elderly patients, short flap surgery time, easy and fast operation, small damage, less surgical complications, high success rate of flap repair, and limb function can be saved to a greater extent.Although the appearance is not that satisfying, the application is safe enough for elderly patients.

关 键 词：负压封闭引流 前臂皮瓣 老年 前臂及手部 深度创面 

分 类 号：R658.2[医药卫生—外科学]