CAJ | 학술논문

目的探讨双套管持续负压引流在闭合性脱套伤治疗中的应用及临床疗效.方法回顾性分析2009年5月至2010年7月收治的13例闭合性脱套伤患者的临床资料,女11例,男2例；年龄19～57岁,平均32.5岁.所有闭合性脱套伤均为单侧,左侧5例,右侧8例；大转子部5例,大转子及臀部4例,大转子及腰骶部2例,大转子及大腿外侧1例,单纯腰骶部1例.损伤面积,15 cm×12 cm～45cm×15 cm.除2例延迟诊断者外,其余均在伤后3d内接受手术治疗.手术采用小切口清创引流,术后放置双套管持续负压引流.当24h引流量＜30 ml时拔除双套管.愈合标准:损伤局部皮肤无缺血坏死,皮下积液消失,局部触诊皮肤无漂浮感,皮肤与筋膜层之间无相对滑动.结果患者术后4～12 d拔除双套管,平均6.3天.13例患者均获得随访,随访时间10～18个月,平均13.7个月.1例患者出现皮肤坏死,经清创、植皮后创面愈合；余12例患者损伤部位的皮下组织均与筋膜层愈合,愈合时间4～10周,平均7.2周.无一例出现深部感染或晚期血源性感染,无全身系统性并发症发生.1例患者置管处切口边缘发生浅表感染,经换药后愈合.结论应用双套管持续负压引流可以有效地治疗闭合性脱套伤,具有安全、微创和经济的优点.
목적 탐토쌍투관지속부압인류재폐합성탈투상치료중적응용급림상료효.방법 회고성분석2009년5월지2010년7월수치적13례폐합성탈투상환자적림상자료,녀11례,남2례；년령19～57세,평균32.5세.소유폐합성탈투상균위단측,좌측5례,우측8례；대전자부5례,대전자급둔부4례,대전자급요저부2례,대전자급대퇴외측1례,단순요저부1례.손상면적,15 cm×12 cm～45cm×15 cm.제2례연지진단자외,기여균재상후3d내접수수술치료.수술채용소절구청창인류,술후방치쌍투관지속부압인류.당24h인류량＜30 ml시발제쌍투관.유합표준:손상국부피부무결혈배사,피하적액소실,국부촉진피부무표부감,피부여근막층지간무상대활동.결과 환자술후4～12 d발제쌍투관,평균6.3천.13례환자균획득수방,수방시간10～18개월,평균13.7개월.1례환자출현피부배사,경청창、식피후창면유합；여12례환자손상부위적피하조직균여근막층유합,유합시간4～10주,평균7.2주.무일례출현심부감염혹만기혈원성감염,무전신계통성병발증발생.1례환자치관처절구변연발생천표감염,경환약후유합.결론 응용쌍투관지속부압인류가이유효지치료폐합성탈투상,구유안전、미창화경제적우점.
Objective To explore clinical effect of double-tube continuous negative pressure drainage in the treatment of Morel-Lavallée leision.Methods We retrospectively analyzed the clinical data of 13 patients with Morel-Lavallée leision,which were diagnosed and treated in our hospital from May 2009 to July 2010.They were 11 women and 2 men,aged from 19 to 57 years (average,32.5 years).All patients underwent operations within 3 days after injury,except for 2 patients whose diagnosis was postponed.The operation was performed with small incision and double-tubes were placed for continuous negative pressure drainage.Double-tubes were not removed until effusion was less than 30 ml/24 hours.The heal was defined as no skin necrosis and subcutaneous hydrops at lesion site,no skin floating and sliding at palpation.Results Double-tubes were removed 4 to 12 days postoperatively (average,6.3 day).All of 13 patients were followed up for an average of 13.7 months (range,10 to 18 months).Skin necrosis occurred in 1 patient.Lesions were healed 4 to 10 weeks postoperatively(average,7.2 weeks).No deep infection or delayed hematogenous infection was found.There were no general systematic complications.Superficial infection at wound site occurred in one patient and healed after wound management.Conclusion Application of double-tube continuous negative pressure drainage is a safe,less invasive,low-cost and effective treatment for Morel-Lavallée leision.