封闭式引流在四川地震伤员创面治疗中的应用
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摘要
目的:探讨封闭式负压引流技术在地震伤皮肤或软组织损伤创面治疗中的疗效。方法:对2008年5月至2008年7月我院8例有皮肤、软组织损伤及伤口感染的四川地震伤员,采用封闭式持续负压引流治疗。结果:VSD治疗时间为7-27天(平均12.8天),行游离植皮、带血管蒂皮瓣转移或直接缝合修复创面。其中3例因气性坏疽截肢术后、创面不规则伴随骨外露及感染,行多次负压引流,最后行皮瓣转移及游离植皮修复创面。结论:与传统的引流及创面处理方式相比,VSD能消除感染,充分引流和刺激创面肉芽组织快速生长,促进创面愈合,在地震伤创面的治疗中发挥重要作用。
Objective:To investigate the effect of vacuum sealing drainage in the treatment of trauma surface of patients traumatized in Sichuan earthquake. Methods: The wound of skin, parenchyma trauma and cut infection of 8 patients treated by vacuum sealing drainage from May 2008 to July 2007. Results: Time of vacuum sealing drainage was 7～27 days, average 12.8 days,the trauma surfaces were all cured directly by vacuum sealing, a free flap, and regional flap transposition. Three patients with bone exposure and infection after amputation were cured by regional flap transposition and a free flap. Conclusion: Compared with traditional drainage and deal manner of wound, vacuum sealing drainage can protect the wound against contamination, evacuate the wound exudates completely, stimulate the growth of granulation tissue, and facilitate the wound healing, so the vacuum sealing drainage plays an important role in treatmentof the trauma surface of patients traumatized in Sichuan earthquake.
Objective:To investigate the effect of vacuum sealing drainage in the treatment of trauma surface of patients traumatized in Sichuan earthquake. Methods: The wound of skin, parenchyma trauma and cut infection of 8 patients treated by vacuum sealing drainage from May 2008 to July 2007. Results: Time of vacuum sealing drainage was 7～27 days, average 12.8 days,the trauma surfaces were all cured directly by vacuum sealing, a free flap, and regional flap transposition. Three patients with bone exposure and infection after amputation were cured by regional flap transposition and a free flap. Conclusion: Compared with traditional drainage and deal manner of wound, vacuum sealing drainage can protect the wound against contamination, evacuate the wound exudates completely, stimulate the growth of granulation tissue, and facilitate the wound healing, so the vacuum sealing drainage plays an important role in treatmentof the trauma surface of patients traumatized in Sichuan earthquake.
引文
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[2]Morykwas M J,Argenta L C,Shelton-Brown EI,et al.Vacuum-assisted closure:a new method for wound control andtreatment:animal studies and basic foundation[J].Ann Plast Surg,1997,38(6):553-562
[3]Hersovisi DJR,Sanders RW,Scaduto JM,et al.Vaccum-assisted wound closure(VAC therapy)for the management of patients with high-energy soft tissue injuries[J].J Orthop Trauma,2003,17(7):683
[4]FleischmannW.Lang E,Kinzl L.Vacuum assisted wound closure after dermatofasciotomy of the lower extremity[J].Unfallchirurg,1996,99(4):283
[5]Mullner T,Mrkonjic L,KwasnyO,et al.The use of negative pressure to promote the healing of tissue defects[J].Br J PlasticSurg,1997,50(3):194
[6]沈波,廖苏平,吴波.韧厚皮片结合封闭式负压吸引治疗感染性大面积皮肤缺损[J].临床外科杂志,2007,15:497Shen bo,liao su ping,wu bo.Curement of large area of infectious skin defects by conbinding blade thickness skin graft with closed suction[J].Journal of Clinical Surgery,2007,15:497
[7]王洪,罗怀灿,杨述华,等.封闭式负压吸引技术治疗四肢骨筋膜室综合征[J].中华创伤骨科杂志,2003,5(4):342Wang hong,Luo huai can,Yang shu hua,et al.Treatment of osteofascial com partment syndrom e with closed negative pressure sucking technique[J].Chinese Journal of Orthopaedic Trauma,2003,5(4):342
[8]Wang XL.Remedy and nursing for bone fracture complicated with clostridial myonecrosis infection[J].Journal of Practical Orthopedics,2007,13(3):192-193.Chinese
[9]陈孝平.外科学[M].北京:人民卫生出版社,2002:223-224Chen xiao ping.Surgery[M].Beijing:people's health press,2002:223-224
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