负压引流技术在地震伤复杂创面的应用
摘要
目的通过对13例地震伤复杂创面负压封闭引流(VSD)应用的回顾性分析,探讨该技术治疗皮肤软组织大面积缺损、感染和深部坏死所形成巨大创面的独特疗效与临床策略。方法 2008年5～8月,应用VSD技术修复汶川地震创伤13例、共15处创面。伴有不同程度的组织坏死、感染和肌腱、骨外露,平均面积168.73cm2,平均创腔1392cm3。清创后将Airen-TM材料覆盖在相应大小的创面上或填入创腔内,持续40～60kPa负压引流,在有效消灭死腔、缩小创面前提下,分别采用自行上皮化愈合、二期直接缝合、游离植皮及皮瓣转移等方法覆盖创面。结果治疗2～7w后,全部创面愈合。11例获随访,时间4～11个月,平均8.3个月,修复质地良好。结论 VSD技术能充分引流和有效控制感染,刺激和诱导肉芽快速生长,迅速收缩创面、填充缺损、消除死腔,为创面修复创造了良好的环境与条件,明显提高修复速率,缩短了治疗周期,弥补了传统方法的诸多缺陷,是一种针对复杂创面的简便、安全、高效、理想的引流方法 。
引文
〔1〕Raffel A B.The use of negative pressure under skin flaps after radical mastectomy[J].Ann Surg,1952,136:1048.
〔2〕Fleischmann W,Becker U,Bischoff M,et al.Vacuum sealing:indication,technique,and results[J].Eur J Orthop Surg Traumatol,1995,5(1):37-40.
〔3〕Andrabi S I,Ahmad J.Negative pressure therapy for laparotomy wounds—a word of caution[J].J Wound Ostomy Continence Nurs,2007,34(4):425-457.
〔4〕SarsamS E,Elliott J P,LamG K.Management of wound complications fromcesarean delivery[J].Obstet Gynecol Surv,2005,60(7):462-473.
〔5〕Susan Mendez-Eastman.Newtreatment for an old problem,negative-pressure wound therapy[J].Nursing,2002,32(5):58-63.
〔6〕Ludemann C M,Pfeffer F.Post-discharge surgical wound infection;what is to be done[J].MMWFortschrMed,2002,144(45):28-32.
〔7〕Morykwas MJ,Argenta L C,Shelton-Brown E I,et al.Vacuum-assisted closure:a new method for wound control and treatment;animal studies and basic foundation[J].Ann Plast Surg,1997,38(6):553-562.
〔2〕Fleischmann W,Becker U,Bischoff M,et al.Vacuum sealing:indication,technique,and results[J].Eur J Orthop Surg Traumatol,1995,5(1):37-40.
〔3〕Andrabi S I,Ahmad J.Negative pressure therapy for laparotomy wounds—a word of caution[J].J Wound Ostomy Continence Nurs,2007,34(4):425-457.
〔4〕SarsamS E,Elliott J P,LamG K.Management of wound complications fromcesarean delivery[J].Obstet Gynecol Surv,2005,60(7):462-473.
〔5〕Susan Mendez-Eastman.Newtreatment for an old problem,negative-pressure wound therapy[J].Nursing,2002,32(5):58-63.
〔6〕Ludemann C M,Pfeffer F.Post-discharge surgical wound infection;what is to be done[J].MMWFortschrMed,2002,144(45):28-32.
〔7〕Morykwas MJ,Argenta L C,Shelton-Brown E I,et al.Vacuum-assisted closure:a new method for wound control and treatment;animal studies and basic foundation[J].Ann Plast Surg,1997,38(6):553-562.
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