负压封闭引流技术在骨科创面修复中的临床应用

目的探讨负压封闭引流术(VSD)治疗严重皮肤损伤的临床疗效;总结VSD技术在骨科损伤中的修复特点。方法对韶关市粤北人民医院骨科收治的45例严重皮肤损伤(复杂创面)患者均使用VSD治疗。结果所有患者创面均得到了完全愈合,其中28例患者行1次VSD引流术后,创面肉芽组织生长良好,肉芽组织红润,颗粒细小,血运丰富,行第2次植皮后植皮成活,创面闭合良好,手术均取得了成功;13例患者行第2次VSD负压引流后,创面肉芽组织生长良好,肉芽组织红润,颗粒细小,血运丰富,行邮票植皮后取得成功;3例骨髓炎患者,经过2次清创VSD引流后,第3次使用皮瓣转移技术最后闭合创面;1例足背肌腱外露的患者因不愿做皮瓣,用VSD负压技术促进肉芽组织生长,经过3次VSD负压引流后,肉芽组织生长良好,配用生肌膏后肌腱全部覆盖肉芽组织,植皮后创面闭合。结论 VSD技术是治疗严重四肢大面积皮肤损伤较好的处理方法。

Clinical Application of Vacuum Sealing Drainage in Wound Repair in Department of Orthopedics

Objective To study the effect of vacuum sealing drainage （VSD） on severe skin injury, and to summarize the characteristics of VSD in wound repair in the department of orthopedics. Methods Forty-five patients with severe skin injury （complex wounds） were treated with VSD in the department of orthopedics of Yuebei People＇s Hospital. Results All wounds healed after VSD. Among the 45 patients, 28 successfully underwent operation and had red and small granulation tissue formation with rich blood supply after the first VSD and skin graft survival with good wound closure after the second skin grafting. Thirteen patients had red and small granulation tissue formation with rich blood supply after the second VSD and successfully underwent stamp skin grafting. Three patients with osteomyelitis underwent VSD twice and achieved wound closure after the third flap transfer. One patient with dorsal foot tendon exposure did not want to undergo flap preparation and received VSD to promote the growth of granulation tissue. After 3 times of VSD, the growth of granulation tissue was good and the tendon covered granulation tissue after using Shengji ointment. The wound closed after skin grafting. Conclusion VSD is an effective method for treating the large area of limb skin injury.