负压封闭引流技术治疗软组织缺损并感染创面.docVIP

负压封闭引流技术治疗软组织缺损并感染创面【摘要】 目的 观察负压封闭引流技术治疗创伤后软组织缺损并感染创面的疗效。方法 回顾性分析我科治疗的严重创伤后软组织缺损并感染创面31例患者,清创后VSD敷料覆盖创面;应用负压封闭引流技术5~7 d,待创面新鲜无感染,肉芽生长饱满后行中厚皮片植皮治疗。结果 平均应用负压封闭引流技术1次,伤口感染控制,肉芽组织新鲜,给予植皮治疗后创面愈合,愈合时间平均为10 d。患者平均住院时间为14 d。结论 负压封闭引流技术在治疗创伤后软组织缺损并感染创面中疗效显著,迅速。 【关键词】负压封闭引流技术;软组织缺损;感染 Treatment of infectious wounds with soft tissue deficiency using vacuum sealing drainage ZHOU Zhi-gang,YAN Zhao-hua,LI Qiang,et al.Department of Orthopeadics,The first people hospital of jiu jiang,jiangxi 332000,China 【Abstract】 Objective To explore the therapeutic effectiveness of vacuum sesling drainage technique in treating the infectious wounds with soft tissue deficiency.Methods We retrospectively investigated 31 patients treated in our department with infectious wounds with soft tissue deficiency.All wounds were debridemented and covered with VSD.VSD was changed every five to seven days until the wound were consided clean and granulation tissue formated.Then the wound were covered with skin flap or split-thickness skin-grafting.Results All the wound infection got controlled,wound size shrinkde,and fresh granulation tissue formated after using VSD for average once.The wounds healed after skin-grafting or flap-transferring.The average healing time was 14 days.Conclusion Vacuum sealing drainage tecnique can cure the infectious wounds with soft tissue deficiency quickly and effectively. 【Key words】Vacuum sealing drainage; Soft tissue deficiency; Infection 作者单位:332000九江市第一人民医院骨科 负压封闭引流技术(vacuum sealing drainage,VSD)相对于现有各种外科引流技术而言是一种革新,它能够彻底除去腔隙,创面分泌物和坏死组织,促进创面愈合,是一种理想的引流方法。2008年5月至2009年11月,我院骨科将其应用于治疗创伤后软组织缺损并感染的复杂创面,明显缩短了治疗时间,减少了患者痛苦,降低了住院费用,疗效显著。现报告如下。 1 资料与方法 1.1 一般资料 本组31例,男26例,女5例。年龄18~50岁。受伤原因:车祸伤20例,爆炸伤3例,绞面机绞伤8例;皮肤软组织缺损面积最大占全身面积5%,最小占1%。 1.2 VSD敷料和粘贴薄膜 VSD敷料是由武汉维斯第医用科技公司生产的一种白色泡沫型合成敷料,成分为聚乙烯醇,无刺激性,抗张力强,有良好可塑性,透水性和生物相容性。粘贴薄膜为英国SN公司生产的施乐辉半透膜,具有良好的生物相容性和透氧透湿性能,对皮肤无刺激,同时防水和防细菌入侵。VSD装置采用病房中心负压吸引,压力维持在-125~-450 mm Hg(-0.017~0.060 MPa)的负压。 1.3 手术治疗 麻醉成功后,患者