Masquelet技术在糖尿病足致感染性创面中的应用  

Application of Masquelet technology in the treatment of infectious chronic wound caused by diabetic foot

作　　者：陈涛 曹飞华 张胜林 何福军 童海俊 CHEN Tao;CAO Feihua;ZHANG Shenglin(Department of Second Orthopedics,Jinhu People's Hospital,Huai'an,Jiangsu,211600,China)

机构地区：[1]淮安市金湖县人民医院骨二科,江苏淮安211600

出　　处：《实用手外科杂志》2023年第1期83-86,共4页Journal of Practical Hand Surgery

摘　　要：目的探讨Masquelet技术在治疗糖尿病足导致的感染性创面中的应用效果。方法2018年2月-2021年2月,采用Masquelet技术治疗糖尿病足导致的感染性创面13例。结果4周后在创面诱导膜及肉芽形成的基础上配合湿润烧伤膏(美宝)持续换药,待创面肉芽组织与周围皮肤同一平面后再行二期植皮手术治疗(患者因长期糖尿病导致血管内膜病变硬化故不考虑选用任何形式的皮瓣修复,而用植皮手术覆盖创面)。结论Masquelet技术在治疗糖尿病足导致的感染性创面中,短期内可有效控制感染,从而避免全身感染引起的感染性休克以及菌血症、毒血症、脓毒血症的危险,并避免因感染进行性扩散导致截肢等更大的损伤;其手术操作简单,疗效可靠,适用于糖尿病足造成的各种类型的耐药菌感染灶,适宜临床推广应用。该技术不仅成为治疗糖尿病足创面的有效手段,同时对于慢性难愈创面及耐药菌感染所导致的感染性创面也有重要作用。Objective To analyze the outcome of applying Masquelet technology in the treatment of infectious chronic wound caused by diabetic foot.Methods Thirteen cases of infectious chronic wound caused by diabetic foot were treated with Masquelet technology.Results After 4 weeks,Moist exposed burn ointiment(MEBO)was treated in the wound healing,according to situation of the wound membrane and granulation tissue.While the granulation tissue was smoothed,the second skin grafting was taken(because of the poor condition of blood vessels caused by basic diseases,skin grafting was performed to cover the wound and any kind of flap repair was not considered to repair the wound).Conclusion Masquelet technology can effectively control infection in the treatment of diabetic foot and infectious chronic wounds in the short time,so as to avoid the risk of systemic infection and reduce the exudate odor caused by inflammatory media produced by diabetic foot and chronic wound.The operation is simple and the effect is reliable.It is suitable for various types of drug-resistant bacterial infection and also suitable for clinical application.It is not only an effective method for diabetic foot wound,but also can be widely used in chronic refractory wound and severe wound with drug-resistant bacteria infection.

关 键 词：马斯昆雷特技术 糖尿病足及感染性慢性创面 湿润烧伤膏(美宝) 胰岛素泵 二期植皮 

分 类 号：R658.3[医药卫生—外科学]