封闭式负压引流技术在植皮术中的应用.docVIP

封闭式负压引流技术在植皮术中的应用 　　[摘要]目的：探讨封闭式负压引流技术（vacuum sealing drainage，VSD）在各种软组织大面积缺损创面植皮术中的临床应用效果。方法：收治的82例需要行植皮治疗的患者，随机分成实验组和对照组。其中实验组32例采用VSD联合植皮术治疗，对照组50例采用传统打包加压植皮术治疗。结果：实验组术后植皮30例，2例皮片边缘坏死，全部成活者的成活率93.75%，1例感染经换药处理后治愈，感染率3.12%；对照组术后植皮34例，12例边缘坏死，4例大部分坏死，全部成活者的成活率68.00%，10例感染经抗炎及换药处理后治愈，感染率20.00%。两组植皮全部成活者的成活率、感染率比较，差异有统计学意义（P0.05）。结论：较之传统加压打包法，应用VSD技术于植皮术中能显著提高植皮成活率，降低植皮感染率，值得临床推广应用。 　　[关键词] 封闭式负压引流技术；大面积缺损创面；植皮 　　[中图分类号]R622 [文献标识码]A [文章编号]1008-6455（2014）21-1763-03 　　Abstract： Objective To investigate the application of the vacuum sealing drainage technology in the dermatoplasty of large area of cutaneous defects. Methods 82 patients which required for skin grafting were randomly divided into experimental group and control group. 32 cases in the experimental group were treated with VSD in skin grafting， 50 cases in the control group using the traditional packing pressure in skin grafting. Results After skin grafting，32 cases in the experimental group survived in 30 cases，2 cases result in skin edge necrosis，the survival rate was 93.75%， 1 case has infection and cured after dressing change，the infection rate was 3.12%； 50 cases in the control group survived in 34 cases，12 cases have marginal necrosis，4 cases have most necrosis， the survival rate is 68%， the infection rate was 20%. Comparing the survival rate and infection rate，the two methods had significant difference by statistical analysis （P0.05）. Conclusion Compared with the traditional compression packing method，the application of VSD technology in the skin grafting can significantly improve the survival rate of skin， reduce skin graft infection rate.It is worthy to promote the VSD technology. 　　Key words：the vacuum sealing drainage technology；large area of cutaneous defects；the shin grafting 　　VSD于1992年由德国ULM大学Fleischman博士首创[1]，并于1993年报道VSD技术用于治疗各种软组织缺损和感染创面[2-3]。该技术主要是用聚乙烯乙醇水化海藻盐泡沫敷料来覆盖创面，再用生物半透膜封闭创面，用引流管接通负压装置，使之成为一个密闭的负压空间来促进创面愈合的一种治疗技术[4-6]。VSD技术于1994年由裘华德教授引进国内，经过近20年的临床探索和研究，VSD技术已经成为治疗难愈性创面的常规