负压封闭引流在严重手部脱套伤中的应用

目的探讨负压封闭引流(Vacuum Sealing Drainage,VSD)在严重手部脱套伤中的应用。方法 2008年来,我科对10例严重手部脱套伤(Ⅱ型)患者采用手掌背全厚皮回植+VSD或手指腹部袋状皮瓣埋植+取植皮+VSD的手术方法进行修复。结果 1周拆除VSD后,发现7例手掌、背皮肤全部存活,3例部分坏死,经换药后愈合或以植皮术修复。腹壁埋植指取出后经植皮、VSD处理后,除1例(3指)出现指端皮肤局部坏死,其余9例均成活,创面I期修复,外观形态满意。结论在严重手部脱套伤中运用负压封闭引流,手术方式相对简单,术后外形和功能满意,住院时间短,病人痛苦少。

Clinical Application of Vacuum Sealing Drainage in Severe Degloving Injury of the Hand.

Objective To evaluate the clinical results of Vacuum Sealing Drainage in repair of severe degloving injury of the hand.Methods Since 2008,10 patients with severe degloving injury of the hand（typeⅡ） were treated by full-thickness skin graft in palm and dorsum of the hand with VSD and fingers embedding in abdominal wall in first stage and skin transplantation in second stage with VSD.Results All skin graft in palm and dorsum of the hand survived well except 3 cases of local necrosis with secondary healing.Skin graft in fingers survived in 9 cases except 1 case of finger tip necrosis in three fingers.Conclusion Vacuum Sealing Drainage in the treatment of severe degloving injury of the hand works conveniently with short treatment cycle and less pain.All patients obtained satisfactory shape and function.