VSD技术结合头皮游离植皮治疗儿童下肢大面积皮肤缺损18例疗效性分析

目的：探讨持续使用负压封闭引流（vacuumsealingdrainage，VSD）装置结合头皮游离植皮治疗儿童下肢大面积皮肤缺损的临床效果。方法：对18例下肢大面积皮肤缺损的患儿，清创后应用负压封闭引流装置，术后1周更换1次并清除创面坏死组织，待创面坏死组织彻底清除，肉芽新鲜时，于头部切取刃厚皮片或中厚皮片，大块或邮票状植于创面，继续应用负压封闭引流装置，1周～10天去除VSD敷料。结果：15例患者植皮完全成活。3例患者去除VSD敷料后，边缘少许坏死，积极换药后愈合，皮片功能均恢复正常。结论：持续应用VSD，使创面引流更加彻底，利于控制感染，促进肉芽生长，术后护理方便；头部取皮植皮，供区隐蔽，可反复切取，结合VSD的应用，植皮的成活率高，是一种较为理想的治疗方法。

Analysis of treatment of children with lower limb large area skin defect in 18 cases by VSD technology combined with the scalp skin graft

Objective To study the continued use of negative pressure closed drainage （vacuum sealing drainage, VSD） device combined with skin grafts take the scalp, treating children lower limb large areas of skin defect in the clinical effect. Methods 18 cases lower limb large areas of skin defect of children, after debridement application negative pressure closed the drainage device, a week after changing one and remove wound necrotic tissue necrosis tissue to wound thoroughly, granulation fresh, to cut off the head of blade thick skin or in thick skin piece, large or stamps shape into the wound, continue to application negative pressure closed the drainage device, 1 weeks to 10 days to remove VSD dressings. Results 15 cases of patients survived skin completely, 3 patients with remove VSD dressing, edge a little necrosis, positive survived after changeover, leather piece of functions are back to normal. Conclusion Continuous application VSD, make the wound more complete drainage, to control infection, promote granulation growth, postoperative nursing convenient; Take to the head skin graft, hidden for area can be repeated cut off, combined with the application of the VSD, graft survival rate high, it is a kind of ideal treatment.