持续封闭负压引流在电击伤后皮肤及软组织损伤中的应用

目的探讨持续封闭负压引流在修复高压电击伤后皮肤及软组织缺损中的疗效。方法32例高压电击伤创面早期清创，一期行持续封闭负压引流，运用其专用敷料覆盖，生物半透膜封闭，视创面情况定期更换敷料，待创面培养出新鲜肉芽组织，二期采用皮辩移植或游离皮片移植封闭创面，观察术后皮瓣及皮片的成活情况。结果16例使用1次持续封闭负压引流后，创面新鲜、肉芽组织生长良好；10例使用2次（更换一次敷料）后创面新鲜、肉芽组织丰富，二期行刃厚皮片或中厚皮片移植，皮片均存活良好；16例创面伴有骨外露，行邻位或随意皮瓣转移，皮瓣存活良好。结论持续封闭负压引流能提高皮片或皮瓣移植成活率，减少创面植皮次数，缩短病程，减轻患者痛苦，便于操作和护理，在治疗电击伤后皮肤及软组织缺损中有良好的临床应用前景。

The Application of Vacuum Sealing Drainage in Repair of the Skin and Tissue Defects after High Voltage Electrical Injury

Objective Explore the effect of vacuum sealing drainage in repair of the skin and tissue defects after high voltage electrical injury. Methods According to 32 cases of high voltage electrical injury from 2010 July to 2012 July treated by early wound debridement in our hospital, a period of sustained a vacuum sealing drainage,using the special dressing and biological semiper- meable membrane closing, change dressing as the wound regularly, after the wound to produce fresh granulation tissue, using the skin flap transplantation or free skin graft to close the wound, observation the survival situation of postoperative flap and skin graft. Re- sults In 16 patients, the wound became fresh and the granulation tissue growth well after using 1 continuous vacuum sealing drain- age. In other 10 patients, the wound became fresh and the granulation tissue growth well after using 2 continuous vacuum sealing drain- age, then the wound edge thickness skin graft or split-thickness skin graft, skin grafts were living well. Among 16 cases of wound with bone exposure, for flap or free flap, flaps survival well. Conclusion Vact~um sealing drainage can improve the survival rate of the skin flap and skin graft, reduce the number of wound skin grafting, shorten the course of disease, alleviate the suffering of patients,and easy to nursing care, so in repair of the skin and tissue defects after high voltage electrical injury with a good prospect of clinical appli- cation.