中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2014年
36期
120-120,121
,共2页
负压封闭引流%骨科
負壓封閉引流%骨科
부압봉폐인류%골과
Vacuum sealing drainage%Skeletal trauma
目的：探讨负压封闭引流在骨科创伤中应用的临床疗效。方法：对2012年6-12月笔者所在医院使用负压封闭引流(vacuum sealing drainage，VSD)治疗的骨创伤36例进行回顾性分析。结果：骨折术后钢板外露、开放性骨折外固定支架患者共17例，在经过1~4次VSD治疗后，创面均无感染且明显缩小，并有新鲜的肉芽组织生长，后期行皮瓣、植皮、内固定治疗或继续外固定支架治疗，经治疗后痊愈；3例骨髓炎经2~4次VSD治疗后，创面明显缩小，有新鲜的肉芽组织生长；感染创面8例应用VSD，配合敏感抗生素的使用，平均使用15 d，感染均得到控制；新鲜软组织缺损创面5例，经1次VSD治疗后均能一期缝合创面或植皮修复创面；3例脓肿切开引流后经1~2次VSD治疗后有肉芽组织生长，均能填平创面或直接缝合创面。所有病例经6~26个月的随访，未发生慢性炎症。结论：负压封闭引流是非常有效的引流手段，促进创面的愈合，增加植皮或皮瓣转移成活率，是一种简单、安全、有效的治疗方法，值得临床推广应用。
目的：探討負壓封閉引流在骨科創傷中應用的臨床療效。方法：對2012年6-12月筆者所在醫院使用負壓封閉引流(vacuum sealing drainage，VSD)治療的骨創傷36例進行迴顧性分析。結果：骨摺術後鋼闆外露、開放性骨摺外固定支架患者共17例，在經過1~4次VSD治療後，創麵均無感染且明顯縮小，併有新鮮的肉芽組織生長，後期行皮瓣、植皮、內固定治療或繼續外固定支架治療，經治療後痊愈；3例骨髓炎經2~4次VSD治療後，創麵明顯縮小，有新鮮的肉芽組織生長；感染創麵8例應用VSD，配閤敏感抗生素的使用，平均使用15 d，感染均得到控製；新鮮軟組織缺損創麵5例，經1次VSD治療後均能一期縫閤創麵或植皮脩複創麵；3例膿腫切開引流後經1~2次VSD治療後有肉芽組織生長，均能填平創麵或直接縫閤創麵。所有病例經6~26箇月的隨訪，未髮生慢性炎癥。結論：負壓封閉引流是非常有效的引流手段，促進創麵的愈閤，增加植皮或皮瓣轉移成活率，是一種簡單、安全、有效的治療方法，值得臨床推廣應用。
목적：탐토부압봉폐인류재골과창상중응용적림상료효。방법：대2012년6-12월필자소재의원사용부압봉폐인류(vacuum sealing drainage，VSD)치료적골창상36례진행회고성분석。결과：골절술후강판외로、개방성골절외고정지가환자공17례，재경과1~4차VSD치료후，창면균무감염차명현축소，병유신선적육아조직생장，후기행피판、식피、내고정치료혹계속외고정지가치료，경치료후전유；3례골수염경2~4차VSD치료후，창면명현축소，유신선적육아조직생장；감염창면8례응용VSD，배합민감항생소적사용，평균사용15 d，감염균득도공제；신선연조직결손창면5례，경1차VSD치료후균능일기봉합창면혹식피수복창면；3례농종절개인류후경1~2차VSD치료후유육아조직생장，균능전평창면혹직접봉합창면。소유병례경6~26개월적수방，미발생만성염증。결론：부압봉폐인류시비상유효적인류수단，촉진창면적유합，증가식피혹피판전이성활솔，시일충간단、안전、유효적치료방법，치득림상추엄응용。
Objective:To explore the clinical effect of vacuum sealing drainage(VSD) to repair skin and soft tissue defects in skeletal trauma.Method:The clinical data of VSD to repair skin and soft tissue defects in 36 cases from June 2012 to November 2012 were retrospectively analyzed.Result:In 17 cases of exposed bones and plates after operation and osteomyelitis open fracture were treated by external fixator following debridement,after application of VSD device 1-4 times,all wound dimensions were decreased,the granulation in the surface of wound were all fresh,second stage closure or skin grafting and internal fixation or external fixator were done successfully to close the wound.In 3 cases of after application of VSD device 2-4 times,the wounds generally were clean,and had no signs of infection or bacterial colonization.In 8 cases of infected wounds,after application of VSD,with positive bacterial culture,application 15 days average.In 5 cases of fresh soft tissue defects after application of VSD device survived completely,in 3 cases o f abscess,after cutting,application of VSD device 1-2 times, the granulation in the surface of wound were all fresh.All patients were followed up for 6 to 26 months without chronic inflammation.Conclusion:The VSD appeared to be the effective treatment of open soft tissue injuries,reduce the times of the traditional method of dressing wound,and increase the survival rate of skin grafting. It is a simple,safe and effective method and is worthy of clinical application.
