CAJ | 학술논문

目的:探讨负压封闭引流(VSD)治疗四肢开放性骨折并大面积软组织缺损及后期植皮术后的疗效.方法:对2009年11月一2011年10月我科收治的四肢开放性骨折伴大面积软组织缺损的52例患者进行随机分组,其中39例行创面封闭式负压引流治疗(VSD组)(其中25例自第一次清创至创面完全愈合全程给予封闭式负压引流;14例仅在清创至植皮术前一段时间内使用VSD),剩余13例行传统常规换药(传统治疗组).比较两组疗效,结果:VSD组与传统治疗组在平均住院时间、入院至行植皮手术时间、植皮术后至创面愈合时间及植皮存活率均有显着差异,(P<0.05),提示有统计学意义.结论:VSD引流效果好,减小污染风险,改善局部血液循环,能促进创面肉芽组织生长,提高移植皮片成活率,能大大缩短开放性骨折并大面积软组织缺损的治疗周期,值得临床推广应用.
목적:탐토부압봉폐인류(VSD)치료사지개방성골절병대면적연조직결손급후기식피술후적료효.방법:대2009년11월일2011년10월아과수치적사지개방성골절반대면적연조직결손적52례환자진행수궤분조,기중39례행창면봉폐식부압인류치료(VSD조)(기중25례자제일차청창지창면완전유합전정급여봉폐식부압인류;14례부재청창지식피술전일단시간내사용VSD),잉여13례행전통상규환약(전통치료조).비교량조료효,결과:VSD조여전통치료조재평균주원시간、입원지행식피수술시간、식피술후지창면유합시간급식피존활솔균유현착차이,(P<0.05),제시유통계학의의.결론:VSD인류효과호,감소오염풍험,개선국부혈액순배,능촉진창면육아조직생장,제고이식피편성활솔,능대대축단개방성골절병대면적연조직결손적치료주기,치득림상추엄응용.
Objective To investigate the vacuum sealing drainage (VSD) for treatment of open fractures of the limbs and a large area of soft tissue defects and the skin grafting of postoperative curative effect. Methods A total of 52 patients from November 2009 to October 2011 who were open fracture of the extremities with large area soft tissue defects were divided into two groups, including 39 cases of which use VSD(group VSD) (of which 25cases since the first debridement and the wound completely healed the whole use VSD;14case use of VSD for a period of time-only from the debridement to skin grafting , the remaining 13routine conventional dressing (traditional treatment group). Comparison of curative effect in two groups. Results in VSD group and conventional therapy group ,there were significantly different in the average length of time from admission to operation time, and the time from skin grafting to wound healing, (P<0.05), that was statisticaly significant. Conclusion: VSD has Better drainage effect, it can reduce the risk of contamination, improve local blood circulation, and promote the growth of granulation tissue, improve the skin graft survival rate, and can greatly shorten the open fractures and large area soft tissue defects of the treatment cycle, it is worthy of clinical application.