骨钻孔术联合VSD治疗四肢长骨骨外露27例疗效观察

摘要：目的观察骨钻孔术联合（Vacucon—sealingdrainage，VSD）（负压封闭引流术）治疗四肢长骨骨外露的效果。方法对27例四肢长骨骨外露患者行骨钻孔术及VSD治疗7～10d，创面肉芽生长良好者行中厚皮片或全厚皮片移植，肉芽生长欠佳者予以二次清创及VSD治疗并待创面肉芽新鲜后植皮。同时选择既往住院的同等面积和深度的骨外露患者21例作为对照组，予以常规银锌霜换药，后期行植皮手术治疗。结果治疗组5例因肉芽未完全覆盖外露骨组织行二次VSD治疗，27例患者皮片成活良好，平均住院天数47．7d，随访6个月无复发。对照组平均住院天数为92．3d。结论骨钻孔术联合VSD治疗四肢长骨骨外露操作简单、安全、疗效确切并可缩短患者住院时间。

The Effect of Bone Drilling Jointed with VSD in Treatment of the Long Exposed Bone of the Limbs in 27 Cases

Objective To observe the curative effect of continuous VSD jointed with bone drilling in treatment of the long exposed bone of the limbs. Methods 27 patients with long exposed bone of the limbs were continuously treated by VSD （ vacuum - sealing drainage） for 7 - 10d after bone drilling. Skin of intermediate thickness or the whole thickness were grafted when the wound＇s granulation grew well. If the granulation didnt grow well, it was to be given subsidiary VSD treatment and be given graft of skin when it became fresh. At the same time, 21 cases of patients in our hospital were cho- sen with the same area and depth wound as the control group . Skin graft was implemented to those in the control group after being dressed by Yinxinshuang. Results 5 cases whose granulation didn＇t completely cover the exposed bones had been given subsidiary VSD treatment. 27 patients＇ grafted skin grew well. The average treating time was 47.7 days. There was no follow - up recurrence in the six months. The average treating time of control group was 92.3 days. Conclusion It is a simple, safe, efficient and effective way to jointly use bone drilling and VSD to treat long bone exposure of limbs.