应用负压封闭引流综合治疗慢性难愈性创面的临床体会

目的 探讨应用负压封闭引流(VSD)综合治疗慢性难愈性创面的临床疗效,为临床应用、推广提供治疗依据.方法 选择40例慢性难愈性创面患者,其中20例行VSD序贯治疗,包括全身综合治疗、创面清创、常规换药、VSD治疗和手术治疗来修复难愈性创面(观察组),20例采用除去VSD治疗的传统治疗(对照组),对两组创面换药次数、创面愈合情况、手术成功率进行比较.结果 40例患者中观察组创面换药次数明显少于对照组[(13.55±6.87)次比(29.25±24.13)次,t=2.319,P<0.05];10例非手术患者中观察组可促进创面愈合,治愈率明显高于对照组(100％比40％,P<0.05);30例手术患者中观察组手术修复成功率明显高于对照组(100％比60％,P<0.05).结论 VSD对于难愈性创面,尤其窦道性创面及肌腱甚至骨质外露创面均有显著效果,值得推广应用.

Clinical experience on the application of vacuum sealing drainage in the comprehensive treatment of chronic refractory wounds

Objective To explore the clinical effect of vacuum sealing drainage (VSD) in the treatment of chronic refractory wounds,and to provide a therapeutic basis for clinical application and popularization.Methods 40 patients with chronic refractory wounds were chosen and divided into two groups,the observation group,20 cases of which were treated with VSD sequential therapy,including systemic treatment in the whole body,wound debridement,traditional dressing changes,the control group,20 cases of which were treated with traditional therapies exclusive of VSD.The method was to analysis and compare the two groups in terms of the indicators,such as the frequencies of wound dressing changes,the performance of wound healing,the ratio of successful operation.Results From the analysis of the 40 cases,the frequencies of wound dressing changes of the observation group were obviously less than that of the control group [(13.55±6.87)vs. (29.25±24.13),t=2.319,P<0.05].In 10 non operative patients,the observation group could promote wound healing,and the cure rate was obviously higher than that of the control group (100% vs. 40%,P<0.05).The successful rate of surgical repair in the observation group of the 30 patients was obviously higher than that of the control group(100% vs. 60%,P<0.05).Conclusions VSD is worthy of be applied widely as obvious effect could be observed in the auxiliary treatment of refractory wounds,especially in the sinus wound,tendon-exposed or bone-exposed wounds.