CAJ | 학술논문

目的：研究负压封闭引流技术（VSD）联合抗菌药物在跟腱术后感染并皮肤缺损患者中的临床应用效果，为临床治疗提供参考。方法选取2007年3月－2013年3月骨科收治的跟腱术后感染伴皮肤缺损患者76例作为研究对象，将2007年3月－2010年3月收治的36例患者作为对照组，采用传统方法治疗，将2010年4月－2013年3月收治的40例患者作为观察组，采用VSD技术联合抗菌药物进行治疗，比较两组患者治疗后的临床疗效。结果患者治疗后优良率观察组为100．0％、对照组为77．8％，两组比较差异有统计学意义（ P＜0．05）；观察组患者治疗后创面愈合时间及住院时间均明显短于对照组患者，两组比较差异有统计学意义（P＜0．05）；观察组患者感染控制率、创面肉芽组织生长良好率及首次植皮成功率均为100．0％，对照组分别为69．4％、61．1％和58．3％，两组比较差异有统计学意义（P＜0．05）。结论 VSD联合抗菌药物治疗能有效控制跟腱术后感染，是治疗创伤性皮肤缺损的有效手段，不仅操作简便、疗效好，还能有效清除创面的分泌物及坏死组织，促进肉芽组织的增生，利于二期植皮成功，且治疗时间明显缩短，值得在临床广泛推广。
목적：연구부압봉폐인류기술（VSD）연합항균약물재근건술후감염병피부결손환자중적림상응용효과，위림상치료제공삼고。방법선취2007년3월－2013년3월골과수치적근건술후감염반피부결손환자76례작위연구대상，장2007년3월－2010년3월수치적36례환자작위대조조，채용전통방법치료，장2010년4월－2013년3월수치적40례환자작위관찰조，채용VSD기술연합항균약물진행치료，비교량조환자치료후적림상료효。결과환자치료후우량솔관찰조위100．0％、대조조위77．8％，량조비교차이유통계학의의（ P＜0．05）；관찰조환자치료후창면유합시간급주원시간균명현단우대조조환자，량조비교차이유통계학의의（P＜0．05）；관찰조환자감염공제솔、창면육아조직생장량호솔급수차식피성공솔균위100．0％，대조조분별위69．4％、61．1％화58．3％，량조비교차이유통계학의의（P＜0．05）。결론 VSD연합항균약물치료능유효공제근건술후감염，시치료창상성피부결손적유효수단，불부조작간편、료효호，환능유효청제창면적분비물급배사조직，촉진육아조직적증생，리우이기식피성공，차치료시간명현축단，치득재림상엄범추엄。
OBJECTIVE To explore the clinical effect of vacuum sealing drainage (VSD) combined with antibiotics on treatment of postoperative infection complicated skin defect in patients undergoing achilles tendon surgery so as to provide guidance for clinical treatment .METHODS A total of 76 patients with postoperative infections compli‐cated with skin defect who underwent the achilles tendon surgery in orthopedics department from Mar 2007 to Mar 2013 were recruited as the study objects;36 patients who were treated from Mar 2007 to Mar 2010 were set as the control group and received the conventional treatment ,and 40 patients who were treated from Apr 2010 to Mar 2013 were assigned as the observation group and were given the VSD combined with antibiotics;the clinical effects were observed and compared between the two groups .RESULTS After the treatment ,the excellent and good rate was 100 .0% in the observation group ,77 .8% in the control group ,there was significant difference between the two groups (P<0 .05) .The wound healing time and length of hospital stay of the observation group were signifi‐cantly shorter than those of the control group(P<0 .05) .The rate of control of infections was 100 .0% in the ob‐servation group ,69 .4% in the control group;the excellent and good rate of growth of wound granulation tissue was 100 .0% in the observation group ,61 .1% in the control group;the rate of successful skin graft for the first time was 100 .0% in the observation group ,58 .3% in the control group ,and there was significant difference (P<0 .05) .CONCLUSION VSD combined with antibiotics may contribute to the effective control of postoperative infections in the patients undergoing achilles tendon surgery and is an effective way to treat traumatic skin defect ,with the operation simple ,the effect good ,and it can effectively eradicate the wound secretions and necrotic tissues ,promote the granulation tissue hyperplasia ,facilitate the successful phase II skin graft ,and remarkably shorten the treatment time ,and it is wor‐thy to be promoted in the hospital .