CAJ | 학술논문

目的：探讨应用封闭负压引流联合网状植皮治疗四肢皮肤脱套伤，代替传统加压包扎回植中厚网状皮片的应用效果。方法回顾2010年8月至2013年6月沈阳军区总医院应用封闭负压引流（VSD）联合中厚网状皮片移植修复四肢皮肤脱套伤24例，其中男16例，女8例，年龄19～56岁。利用封闭负压引流技术代替传统加压包扎技术，7～10 d 后拆除 VSD 装置，观察治疗后植皮成活情况。结果24例患者中16例经过1次手术完成创面覆盖，6例经过2次手术完成创面覆盖，2例患者因肢体挤压伤严重，回植皮片小面积成活且伴有肌肉肌腱外露，后经多次游离植皮及游离皮瓣转移术消灭创面。结论封闭式负压引流技术联合网状皮片移植治疗外伤导致的四肢皮肤脱套伤，能对皮片均匀加压并充分引流坏死组织，起到控制感染、促进植皮成活的效果，值得临床推广。
목적：탐토응용봉폐부압인류연합망상식피치료사지피부탈투상，대체전통가압포찰회식중후망상피편적응용효과。방법회고2010년8월지2013년6월침양군구총의원응용봉폐부압인류（VSD）연합중후망상피편이식수복사지피부탈투상24례，기중남16례，녀8례，년령19～56세。이용봉폐부압인류기술대체전통가압포찰기술，7～10 d 후탁제 VSD 장치，관찰치료후식피성활정황。결과24례환자중16례경과1차수술완성창면복개，6례경과2차수술완성창면복개，2례환자인지체제압상엄중，회식피편소면적성활차반유기육기건외로，후경다차유리식피급유리피판전이술소멸창면。결론봉폐식부압인류기술연합망상피편이식치료외상도치적사지피부탈투상，능대피편균균가압병충분인류배사조직，기도공제감염、촉진식피성활적효과，치득림상추엄。
Objective Toexploretheapplicationofvacuumsealingdrainage(VSD)combinedwith mesh skin graft on treating with limbs skin degloving injury, instead of yarn package pressurized technology. Methods From August 2010 to June 2013, there were 24 cases of patients with limbs skin degloving injury, including 16 males and 8 females, aged 19~56 years. All the patients were treated with the vacuum sealing drainage instead of yarn package pressurized technology, 7~10 days later,dismantling the VSD device,to record skin graft survival after treatment. Results 16 cases in 24 patients completed coverage of the wound after an operation, 6 cases completed coverage of the wound after two operation. Two patients due to severe crush injuries, a small area of grafted skin survived and accompanied by slices of muscle tendon exposure, after several free skin graft and free flap transfer surgery to eliminate wound. Conclusion Vacuum sealing drainage combined with mesh skin graft on treating with limbs skin degloving injury, can uniform pressure and adequate drainage of necrotic tissue,and control the infection, then promote the survival of grafted skin, worthy of clinical promotion.