负压封闭引流在手部复杂损伤治疗中的辅助作用

目的：观察负压封闭引流（vacuum sealing drainage, VSD）在手部开放性复杂损伤早期治疗中的辅助应用效果，并评估其适用性。方法对17例手部开放性复杂创面采用VSD治疗，控制感染，局部组织修复条件改善后，选用合适方式闭合创面，并随访创面恢复、骨折愈合及并发症等情况。结果14例经1次VSD、3例经2次VSD治疗后，11例采用游离皮片移植、6例采用皮瓣移植闭合创面。除1例复合移植皮瓣出现部分边缘表层组织坏死外，其余均甲级愈合，所有骨折均骨性愈合，未发现感染、皮肤溃疡、窦道等并发症，手部功能和外观恢复较满意。结论 VSD能够促进手部复杂创面安全、快速的修复，是一种相对简单、有效的辅助治疗方法。

The auxiliary function of vacuum sealing drainage in the treatment of complex hand injury

Objective To observe the effect of vacuum sealing drainage （VSD） in the early treatment of open complex hand injury, and assess its applicability. Methods 17 cases with the injury area were treated by VSD. When local infections were controlled and wound conditions were improved, the appropriate way was choosen to close the wound. And wound recovery, fracture healing and complications were followed up. Results After 14 cases treated with 1 times of VSD, 3 cases with 2 VSD, the wounds were covered by free skin graft in 11 cases, 6 cases by flap. Except for partial tissue necrosis in 1 case of compound flap, wounds developed well, and all fractures healed. There were no complications, such as infection, skin ulce, sinus. Hand function and appearance recovered satisfactorily. Conclusion VSD can promote the safe and rapid recovery of complex hand wound, so it can act as a relatively simple, effective auxiliary treatment.