CAJ | 학술논문

目的：探讨负压封闭引流技术联合皮瓣转移术在深度褥疮合并骨感染创面治疗的临床效果及应用价值。方法将我科2009年4月至2013年6月，行深度褥疮合并骨感染创面修复患者40例，随机分成普通组（20例）和治疗组（20例），普通组在手术清创之后实施Ⅰ期皮瓣转移修复创面，治疗组在手术清创之后首先使用负压封闭引流装置治疗，其后再行Ⅱ期皮瓣转移修复创面手术，对比两组治疗效果。结果普通组患者中有13例在Ⅰ期愈合，愈合率65．00％，7例患者出现皮瓣下窦道，其中2例患者采取保守换药治疗后痊愈，5例患者再次实施了手术后痊愈；治疗组患者Ⅱ期创面手术前全部生长出肉芽且生长良好，将大部分外露骨质覆盖住，且创面无明显分泌物，呈现清洁状态，在实施皮瓣转移修复后所有患者在Ⅰ期愈合，愈合率100．00％。结论对深度褥疮合并骨感染创面修复患者采用负压封闭引流联合皮瓣转移术治疗，临床效果确切，值得推广应用。
목적：탐토부압봉폐인류기술연합피판전이술재심도욕창합병골감염창면치료적림상효과급응용개치。방법장아과2009년4월지2013년6월，행심도욕창합병골감염창면수복환자40례，수궤분성보통조（20례）화치료조（20례），보통조재수술청창지후실시Ⅰ기피판전이수복창면，치료조재수술청창지후수선사용부압봉폐인류장치치료，기후재행Ⅱ기피판전이수복창면수술，대비량조치료효과。결과보통조환자중유13례재Ⅰ기유합，유합솔65．00％，7례환자출현피판하두도，기중2례환자채취보수환약치료후전유，5례환자재차실시료수술후전유；치료조환자Ⅱ기창면수술전전부생장출육아차생장량호，장대부분외로골질복개주，차창면무명현분비물，정현청길상태，재실시피판전이수복후소유환자재Ⅰ기유합，유합솔100．00％。결론대심도욕창합병골감염창면수복환자채용부압봉폐인류연합피판전이술치료，림상효과학절，치득추엄응용。
Objective To investigate the clinical effect and therapeutic value of VSD flap surgery combined with bone infection in the wound deep bed sores.Methods Forty patients with bone deep bedsores infected wound repair after surgical debridement in our depart-ment from April 2009 to June 2013 were recruited in the study.The general group was implementedⅠflap repair of wounds after surgical de-bridement.The treatment group was firstly performed the therapy of vacuum sealing drainage device,and subsequently phaseⅡflap surgery to repair the wound.The therapeutic effect of the two groups was compared.Results Patients with normal group had 13 cases in Ⅰ healing, with the healing rate of 65.00%,and 7 patients had sinus flap,among whom 2 were cured after taking a conservative dressing,5 recovered after surgery was carried out again;treatment group patients had wound granulation before surgery in phase Ⅱ and all grew well,covering most of the exposed bone,and there were no obvious wound secretions,showing a clean state,and after the implementation of the flap repair in all pa-tients healingⅠ,the healing rate was 100.00%.Conclusion For the depth of wound healing of pressure ulcers in patients with bone infec-tions using vacuum assisted closure flap in the treatment has significant clinical effect,which should be widely applied.