立用VSD负压引流技术治疗皮肤软组织缺损的疗效观察和护理措施的完善

【摘要】目的应用VSD负压引流技术治疗皮肤软组织缺损的疗效观察及新护理方法的使用和推广。方法本院骨科2010年4月～2012年8月应用VSD负压引流护理技术治疗皮肤软组织缺损116例．并且按照要求进行了严密观察和精心护理。结果116例患者，除1例其他原因转上级医院治疗，l例因皮肤挫灭重、皮损面积大、骨外露，且糖尿病血糖控制不理想，2例高位截瘫臀部巨大压疮皮肤软组织缺损重导致病程较长外，其余112例均在彻底清创，应用~SD负压引流技术治疗，78例治疗5～7d，34例治疗10～20d，拆除负压引流装置后，行二次修复手术（植皮或皮瓣移植）创面愈合良好。结论VSD负压引流技术治疗皮肤软组织缺损，加之正确的护理方法，为二次修复创造了良好条件，且二次修复手术后，创面愈合快，感染率低，既说明了VSD负压引流技术是皮肤软组织缺损确实有效的治疗方法，正确的护理方法同样是治疗成功的可靠保证．适用于临床广泛应用。

Effect observation of skin and soft tissue defects treated by vacuum sealing drainage and improvement of nursing measures

Objective To observe the efficacy of skin and soft tissue defects treated by vacuum sealing drainage （VSD） and promote the new nursing methods. Methods One hundred and sixteen patients suffering from skin and soft tissue defects admitted into our orthopedics department from April 2010 to August 2012 were treated by VSD and also pro- vided with close observation and intensive care as requirement. Results Among 116 participants, except 1 patient transferred to superior hospital due to other reasons, 1 diabetic patient with severe skin damage, large were skin le- sions, bone exposure, and unsatisfactory control of blood glucose, and two high paraplegia patients with hip large pres- sure sore in prolonged treatment due to severe skin and soft tissue defects, the rest were treated by VSD after thorough debridement. 78 patients were treated for 5-7 days, and 34 participants were lasted for 10-20 days. The satisfying wound healing effect was obtained in the second repair surgery including skin grafting and skin flap transplantation af- ter removing VSD device. Conclusion In the treatment of skin and soft tissue defects, VSD combining with proper nursing measures not only sets a good condition for the second repair surgery, but also has advantages of fast wound healing and low infection after a second repair surgery. It indicates the VSD is an effective therapeutic method to treat skin and soft tissue defects. Meanwhile, the proper nursing method is a reliable guaranty for a successful treatment. They are worthy of extensive application in clinic.