负压创面治疗技术在骨科的应用进展  

Progress on the application of negative pressure wound treatment technique in orthopedics

作　　者：李自军 李松军 黄志明 Li Zijun;Li Songjun;Huang Zhiming(The first orthopedics department,the fifth affiliated hospital(Zhuhai)of Zunyi Medical University,Zhuhai,Guangdong,519100,China)

机构地区：[1]遵义医科大学第五附属(珠海)医院骨一科,广东珠海519100

出　　处：《齐齐哈尔医学院学报》2023年第8期762-766,共5页Journal of Qiqihar Medical University

基　　金：珠海市科技局项目(810090918032)。

摘　　要：负压创面技术(NPWT)作为临床上创面管理的常用方法之一,在骨科、烧伤科、感染科等科室广为应用。NPWT已知可通过特制的海绵状敷料和引流管,创造伤口局部负压环境,形成有助于伤口愈合、组织修复、感染防治的生理微环境。并且,不同于传统方法需要频繁换药,应用NPWT可维持较长时间。保证创面湿润,减少敷料摩擦对肉芽床的刺激,防止频繁换药时创面暴露于病原体。但是单纯的NPWT应用有时也无法满足患者复杂的病情和临床医生的要求,因此近年来NPWT技术也得到了多方面的改进,包括但不限于联用氧疗、冲洗等。同时,其使用范围也得到了扩展,最近的研究中临床医生们也在探索NPWT应用于一期缝合的闭合切口的可能性和有效性。但是,尽管NPWT已在实质上成为临床常用的方法之一,其作用原理及有效性方面并不都有足够的证据,所以对NPWT临床应用我们依旧需要更多的研究及证明。Negative pressure wound therapy(NPWT)is widely used in orthopedics,burns surgery and infectious disease as one of the common methods of wound management.NPWT is known to create a locally negative pressure situation around wounds through specially designed sponge dressings and drainage tubes,forming a physiological micro-environment that helps to wound healing,tissue repair and infection prevention.Meanwhile,unlike traditional methods that require frequent dressing changes,the application of NPWT can be maintained for a longer period of time.It ensures moistening of the wound surface,reduces the irritation of the granulation bed by dressing friction,and prevents exposure of the wound surface to pathogens.However,the simple application of NPWT sometimes cannot meet the complex conditions of patients and the requirements of clinicians,so in recent years,NPWT techniques have been improved in many ways,including but not limited to the combination of oxygen therapy and irrigation.At the same time,its indication has been expanded,and clinicians in recent studies have been exploring the possibility and effectiveness of NPWT application in closed incisions with one-stage sutures.But on the other hand,although NPWT has substantially become one of the most common clinical methods,there is not always sufficient evidence on its mechanism and effectiveness.Therefore,more research and evidence are still required on the clinical application of NPWT.

关 键 词：负压疗法 负压封闭引流 骨科 感染 

分 类 号：R641[医药卫生—外科学]