负压封闭引流装置在大面积皮肤缺损植皮中的应用

目的探讨负压封闭引流（VSD）装置在大面积游离植皮手术中的价值。方法通过前瞻性随机对照研究，将64例因大面积皮肤缺损而需要进行游离植皮的患者术前随机分成两组（每组32例），分别用传统打包技术（传统打包组）和VSD装置（VSD组）加压固定皮片，以手术时间、皮片成活率和创面感染率为评价指标进行比较。结果传统打包组手术时间（77±16）min，VSD组（834±12）min，两组手术时间差异无统计学意义（P=0．06）；皮片坏死率和局部创面感染例数打包组为（204-7）％和6例，VSD组为（6±1）％和1例，VSD组患者皮片坏死率和局部创面感染率明显优于传统打包组患者（P〈0．001，P=0．039）。结论大面积皮肤缺损游离植皮覆盖创面时应用VSD装置可以显著提高手术疗效。

The clinical application of the vacuum sealing drainage technology in the dermatoplasty for large area of cutaneous defects

Objective To explore the value of the use of the vacuum sealing drainage technology （VSD） in the dermatoplasty for large area of cutaneous defects. Methods By a prospective randomized study, 64 patients with large area of cutaneous defects were randomly divided into traditional packaging group （dermatoplasty with the traditional dermatoplastic package method,n = 32 ） and VSD group （dermatoplasty with the vacuum sealing drainage technology, n = 32）. Operating time, survival rate of skin graft and wound infection were compared between these two groups. Results There was no significant difference in the operation time between the two groups（ [77 ± 16]min vs [83 ± 12] min,P =0. 06）. The survival rate of skin graft and wound infection in VSD group were significantly better than those in traditional packaging group （survival rate of skin graft：（6 ±1）% vs （20 ±7）% ,P 〈0. O01;wound infection cases：l vs 6,P=0.039）. Conehmion Treating large area of cutaneous defects by the dermatoplasty with VSD technology could significantly improve clinical efficacy.