慢性难治性创口清创减张缝合VSD综合治疗方案临床分析  

Clinical analysis of the comprehensive treatment plan involving debridement,tension⁃reducing sutures,and VSD for chronic refractory wounds

作　　者：陈恩铭 李玉希[1] 李明[1] 黄霖[1] CHEN En-ming;LI Yu-xi;LI Ming;HUANG Lin(Department of Orthopedics,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,Guangdong,510120)

机构地区：[1]广东省广州市中山大学孙逸仙纪念医院骨外科,510120

出　　处：《岭南急诊医学杂志》2024年第2期133-136,共4页Lingnan Journal of Emergency Medicine

基　　金：广东省自然科学基金-青年提升项目(2023A1515030230)。

摘　　要：目的:分析27例通过清创减张缝合封闭式负压引流技术(VSD)综合治疗方案在解决慢性难治性创口术后愈合不良问题中应用的疗效。方法:回顾性分析27例2019年12月-2023年11月我院骨科应用VSD综合治疗方案治疗慢性难治性创口的临床资料,记录患者创面不愈合时间、VSD次数、愈合时间、血红蛋白含量、白蛋白含量,评估VSD综合治疗方案在治疗慢性难治性创口术后愈合不良问题中的作用。结果:共27例不同原因导致大面积或复杂创面不愈合的病人,在经过平均2.1次VSD引流术后采用多层减张缝合闭合创面。在入我科行VSD综合治疗后,创面愈合时间5-56(平均23.2)天,术后随访2-36月,伤口均愈合良好,无复发。结论:清创减张缝合VSD综合治疗方案在治疗慢性难治性创口术后愈合不良问题中有着良好的疗效。Objective:This study aims to evaluate the effectiveness of a comprehensive treatment plan involving vacuum sealing drainage(VSD),debridement,and tension⁃reducing sutures in addressing poor postoperative healing of chronic refractory wounds in 27 cases.Methods:Retrospectively analyzed clinical data from 27 cases of chronic refracto⁃ry wounds treated with the VSD comprehensive treatment plan in the Orthopedics Department of our hospital between De⁃cember 2019 and November 2023.Recorded parameters such as wound non⁃healing time,number of VSDs used,heal⁃ing time,hemoglobin content,and albumin content to assess the effectiveness of the VSD comprehensive treatment pro⁃gram in managing poor postoperative healing of chronic refractory wounds.Results:A cohort of 27 patients with large or complex wounds,which failed to heal due to various reasons,underwent treatment with multi⁃layer tension⁃reducing su⁃tures for wound closure following an average of 2.1 VSD drainage procedures.Following admission for comprehensive VSD treatment,the average wound healing time was 23.2 days(range:5-56 days),with postoperative follow⁃up rang⁃ing from 2 to 36 months.All wounds exhibited successful healing without recurrence.Conclusion:The comprehensive treatment plan involving debridement,tension reduction,and suturing has shown positive efficacy in the management of chronic refractory wounds with poor postoperative healing.

关 键 词：封闭式负压引流技术 慢性难治性创口 愈合不良 

分 类 号：R641[医药卫生—外科学]