负压封闭引流联合逆行隐神经营养皮瓣移植治疗糖尿病足溃疡创面  

Vacuum Sealing Drainage Combined with Retrograde Saphenous Neurocutaneous Flap Transplantation in the Treatment of Diabetic Foot Ulcer Wounds

作　　者：董学刚 王平平 王丰艳 赵峻 DONG Xuegang;WANG Pingping;WANG Fengyan;ZHAO Jun(Department of Medicine,Qingdao University,Qingdao 266021,Shandong,China;Department of Wound Surgery,Qingdao Municipal Hospital,Qingdao 266011,Shandong,China)

机构地区：[1]青岛大学医学部,山东青岛266021 [2]青岛市市立医院创面外科,山东青岛266011

出　　处：《中国美容医学》2024年第9期33-36,共4页Chinese Journal of Aesthetic Medicine

摘　　要：目的:分析负压封闭引流(Vacuum sealing drainage,VSD)联合逆行隐神经营养皮瓣移植治疗糖尿病足溃疡(Diabetic foot ulcer,DFU)创面的疗效。方法:回顾性分析2020年7月-2023年3月笔者医院收治的92例DFU患者,按治疗方式的不同分成对照组(47例)和观察组(45例)。对照组开展逆行隐神经营养皮瓣移植治疗,观察组在对照组基础上联合VSD。统计比较两组患者溃疡面积变化、创面恢复情况、疼痛好转时间、并发症发生情况及截肢情况。结果:两组术后2周、4周溃疡面积和术前比较均明显缩小(P<0.05),且观察组缩小情况较对照组明显(P<0.05);观察组总有效率为87.23%,明显高于对照组的64.44%(P<0.05);观察组创面愈合时间、疼痛好转时间、肢端感觉恢复时间均明显短于对照组(P<0.05);观察组并发症发生率为2.13%,明显低于对照组的17.78%(P<0.05),观察组截肢率(4.26%)和对照组(13.33%)比较差异无统计学意义(P>0.05)。结论:对DFU患者实施VSD联合小腿部位带蒂皮瓣移植治疗,可促进创面愈合、疼痛好转及肢端感觉恢复,减少皮瓣坏死等并发症的发生,并能在一定程度上降低截肢风险。Objective To analyze the efficacy of vacuum sealing drainage(VSD)combined with retrograde saphenous neurocutaneous flap transplantation in treating diabetic foot ulcer(DFU)wounds.Methods A retrospective analysis was conducted on 92 patients with DFU admitted to the author's hospital from July 2020 to March 2023.According to different treatment methods,they were grouped into a flap transplantation group(47 cases)and an observation group(45 cases).The skin flap transplantation group carried out retrograde saphenous neurocutaneous flap transplantation,while the observation group combined VSD on the basis of the skin flap transplantation group.The changes in ulcer area,wound recovery,pain improvement time,incidence of complications,and amputation status of the patient were statistically compared between the two groups.Results The ulcer area of the two groups decreased obviously at 2 and 4 weeks after surgery compared to before surgery(P<0.05),and the reduction in the observation group was more obvious than that in the flap transplantation group(P<0.05).The total effective rate of the observation group(87.23%)was obviously higher than that of the flap transplantation group(64.44%)(P<0.05).The wound healing time,pain improvement time,and limb sensation recovery time of the observation group were obviously shorter than those of the skin flap transplantation group(P<0.05).The incidence of complications in the observation group(2.13%)was obviously lower than that in the flap transplantation group(17.78%)(P<0.05),and there was no statistically obvious difference in amputation rate(4.26%)compared to the flap transplantation group(13.33%)(P>0.05).Conclusion The combination of VSD and retrograde saphenous neurocutaneous flap transplantation for DFU patients can promote wound healing,improve pain,and restore limb sensation,reduce complications such as flap necrosis,and to some extent reduce the risk of amputation.

关 键 词：负压封闭引流 逆行隐神经营养皮瓣 糖尿病足溃疡 创面 修复 

分 类 号：R622[医药卫生—整形外科]