CAJ | 학술논문

目的探讨封闭式负压引流术(VSD)在治疗毁损性手外伤中的应用效果.方法 2006年1月至2008年12月收治毁损性手外伤患者40例(40个创面),均为手部一元或多元组织毁损缺失者.所有患者创面先行清创后,随机分为两组:VSD组20例和对照组(洗必泰湿敷)20例,并应用疼痛指数、肿胀指数、细菌检测、创面继发组织坏死指标进行评价.结果治疗后3dVSD组疼痛指数为(2.62±1.54)分,对照组疼痛指数为(3.39±1.64)分,两组比较差异有统计学意义(P＜0.01);VSD组肿胀指数为(1.51±0.25)分,与对照组的(2.29±1.26)分比较差异有统计学意义(P＜0.05);VSD组细菌阳性率为5%(1/20),对照组为20%(4/20),两组比较差异有统计学意义(P＜0.05);VSD组没有发生创面继发组织坏死,对照组出现2例创面继发组织坏死,其中有1例出现严重组织坏死,采取部分坏死肢体解脱术.结论 VSD可以控制感染,免除换药,减轻疼痛,刺激肉芽组织生长,为组织移植提供良好的条件.VSD联合组织移植为毁损性手外伤治疗的一种理想方法.
목적 탐토봉폐식부압인류술(VSD)재치료훼손성수외상중적응용효과.방법 2006년1월지2008년12월수치훼손성수외상환자40례(40개창면),균위수부일원혹다원조직훼손결실자.소유환자창면선행청창후,수궤분위량조:VSD조20례화대조조(세필태습부)20례,병응용동통지수、종창지수、세균검측、창면계발조직배사지표진행평개.결과 치료후3dVSD조동통지수위(2.62±1.54)분,대조조동통지수위(3.39±1.64)분,량조비교차이유통계학의의(P＜0.01);VSD조종창지수위(1.51±0.25)분,여대조조적(2.29±1.26)분비교차이유통계학의의(P＜0.05);VSD조세균양성솔위5%(1/20),대조조위20%(4/20),량조비교차이유통계학의의(P＜0.05);VSD조몰유발생창면계발조직배사,대조조출현2례창면계발조직배사,기중유1례출현엄중조직배사,채취부분배사지체해탈술.결론 VSD가이공제감염,면제환약,감경동통,자격육아조직생장,위조직이식제공량호적조건.VSD연합조직이식위훼손성수외상치료적일충이상방법.
Objective To evaluate the effect of vacuum sealing drainage(VSD)ON the destroyed hand injuries.Methods From January 2006 to December 2008,forty pafients with destroyed hand injuries (surface of wound)were randomly divided into VSD group(20 cases)and control group(chlorhexidine wet compress)(20 cases)after debridement. The outcomes were retrospectively analysed by pain score,swelling score,bacterial positive rate and necrotic tissue.Results Three days after treatment,the pain score of VSD group was(2.62±1.54)degree,and that of control group was(3.39±1.64)degree.There wag significant difference between the two groups(P＜0.01).The swelling score of VSD group was(1.51±0.25)degree which was different from control group(2.29±1.26)degree(P＜0.05).The bacterial positive rate of control group was 20%(4/20),but that of VSD group was 5%(1/20).There was significant difference between the two groups(P＜0.05).The VSD group had no necrotic tissue occurrence,but the control group had 2 cases,one of which had serious necrosis and had escapology.Conclusion VSD Can inhibit bacterial infection,ease pain,exempt changing dressings and stimulate growing of granulation tissue also can maintain a good environment for tissue transplantation later.So VSD combining with tissue transplantation is an ideal therapy in destroyed hand injuries.