负压封闭引流（VSD）技术治疗皮肤严重毁损伤患者的护理.docVIP

负压封闭引流（VSD）技术治疗皮肤严重毁损伤患者的护理 　　doi：10.3969/j.issn.1007-614x.2014.3.81 　　摘 要 目的：探讨负压封闭引流（VSD）技术治疗皮肤严重毁损伤患者的护理方法。方法：采用VSD装置植入术治疗下肢皮肤严重毁损伤患者5例，回顾临床资料及护理效果。结果：5例创面经VSD技术治疗后，创面愈合良好，无护理并发症。结论：VSD技术在骨科应用护理重点：术前护理包括评估患者健康状况，做好心理护理，备皮、备血及术前用药；术后护理包括监测生命体征，持续负压吸引及保持引流管通畅，观察引流液及掌握引流瓶的处理，观察患肢末端血运情况，常见故障的排除，及对患者和家属有效的健康教育。 　　关键词 负压封闭引流 皮肤严重毁损伤 患者护理 　　Nursing of severe skin damage patients treated with Vacuum sealing drainage（VSD） 　　Zhang Yanfen，Li Yan 　　Second Department of surgery of Mingshan District Peoples Hospital of Yaan City，Sichuan Province，625100 　　Abstract Objective：To explore the nursing of severe skin damage patients treated with Vacuum sealing drainage（VSD）.Methods：The clinical datas and nursing efficacy of 5 cases with severe skin damage treated with Vacuum sealing drainage were retrospectively analysed.Results：In the 5 patients treated with Vacuum sealing drainage，the wound healed well and there were no nursing complications.Conclusion：The nursing key of application of VSD technology in the Department of orthopedics：Preoperative nursing included assessment of the health status of the patients，psychological nursing，skin and blood preparation and preoperative medication；Nursing after operation included monitoring of vital signs，continuous negative pressure suction and drainage tube patency，observing drainage and the master of processing of drainage bottle，observing the limb end blood supply，the exclusion of common faults and effective health education on the patients and their families. 　　Key words Vacuum sealing drainage；Serious skin damage；Patient care 　　VSD是一种全方位、高效的引流方法，因其是在一个密闭的系统内进行，负压吸引使引流区的渗出物和坏死组织被及时清除，使引流区内达零聚积，能显著加快感染腔隙的闭合和感染创面的愈合，防止细菌入侵，有效控制感染，已骨科处理皮肤软组织损伤或毁损伤对广泛使用，并得到充分肯定。2013年1-11月采用VSD装置植入术治疗下肢皮肤严重毁损伤患者5例，其中2例二次使用VSD，取得满意的效果，现报告如下。 　　资料与方法 　　本组患者5例，男3例、女2例，年龄14～61岁，平均37岁。致伤原因：车祸伤3例，地震伤1例，狗咬伤1例。受伤至手术时间2～96小时。受伤程度：5例患者均为单侧肢体（下肢）皮肤严重毁损伤，其中单纯皮肤及软组织毁损伤2例，合并有骨折3例。 　　治疗方法：清创：将坏死组织及腔隙中已失活的组织、渗液和异物彻底清除。覆盖VSD敷料：取与创面大小相似的VSD一块覆盖创面，使其充分与创面完全接触，将VSD