CAJ | 학술논문

目的：探讨负压封闭引流基础上行背阔肌桥式游离皮瓣修复难治性创面的护理效果。方法选择2009年1月至2012年1月期间来我院烧伤科就诊的难治性创面患者37例为观察组，对照组选自2006年1月至2008年12月采用传统创面护理方式的难治性创面患者26例。对照组采取常规方法进行创面护理后行创面2期背阔肌桥式游离皮瓣修复，观察组采用VSD辅料行创面负压封闭引流后行创面2期背阔肌桥式游离皮瓣修复。治疗后密切观察两组患者换药时间、间隔及换药次数、住院天数并比较皮瓣修复后8、16 d护理疗效。结果观察组治疗后换药时间、住院天数显著少于对照组（P＜0.05），换药次数较对照组有极显著性缩短（P＜0.01），换药间隔较对照组有极显著性差异（ P＜0.01）；对照组2例患者皮瓣修复后效果较差，观察组未出现显著的坏死，比较两组良好率，观察组患者良好率显著高于对照组（ P＜0.01）；对照组治疗后1例改善患者转为良好，1例疗效差者转为改善，观察组治疗的良好率显著优于对照组（ P＜0.01）。结论采用负压封闭引流基础上行背阔肌桥式游离皮瓣修复有助于难治性创面恢复，效果显著。
목적：탐토부압봉폐인류기출상행배활기교식유리피판수복난치성창면적호리효과。방법선택2009년1월지2012년1월기간래아원소상과취진적난치성창면환자37례위관찰조，대조조선자2006년1월지2008년12월채용전통창면호리방식적난치성창면환자26례。대조조채취상규방법진행창면호리후행창면2기배활기교식유리피판수복，관찰조채용VSD보료행창면부압봉폐인류후행창면2기배활기교식유리피판수복。치료후밀절관찰량조환자환약시간、간격급환약차수、주원천수병비교피판수복후8、16 d호리료효。결과관찰조치료후환약시간、주원천수현저소우대조조（P＜0.05），환약차수교대조조유겁현저성축단（P＜0.01），환약간격교대조조유겁현저성차이（ P＜0.01）；대조조2례환자피판수복후효과교차，관찰조미출현현저적배사，비교량조량호솔，관찰조환자량호솔현저고우대조조（ P＜0.01）；대조조치료후1례개선환자전위량호，1례료효차자전위개선，관찰조치료적량호솔현저우우대조조（ P＜0.01）。결론채용부압봉폐인류기출상행배활기교식유리피판수복유조우난치성창면회복，효과현저。
Objective To explore nursing effect evaluation of vacuum sealing drainage based latissimus dorsi bridge free skin flap to repair refractory wound.Methods 37 cases of patients with intractable wounds were chosen into observation group between January 2009 and January 2012 , and 26 cases were chosen into control group from January 2006 to December 2008.Cases in control group adopted conventional methods wound nursing before the wound phase 2 latissimus dorsi bridge free skin flap repair, in the observation group accepted VSD accessories line wound negative pres-sure closed drainage before the wound phase 2 latissimus dorsi bridge free skin flap repair.After treatment, dressing time, interval and dressing change, the times of hospitalization days and care curative effect after skin flap to repair 8 days, 16 day were compared.Results Dressing time, hospitalization days in observation group after treatment were sig-nificantly less than those of control group ( P<0.05) , number of dressing was significantly shortened compared with con-trol group ( P<0.01 ) , there was significant difference in dressing change interval between observation group and control group (P<0.01) .There were 2 patients in control group whose repair effect after skin flap were poorer.There was no patient in the observation group who did not appear significant necrosis.Good rate of observation group was higher than that of control group ( P<0.01) .There was 1 patient became well, 1 patient became improving.Conclusions Using negative pressure closed drainage based ascending latissimus dorsi bridge free skin flap repair could cure the refractory wound recovery significantly and the effect is obvious.