VSD技术在大面积皮肤缺损手术设计中的应用

目的：探讨封闭式负压引流（vacuum sealing drainage,VSD）在大片皮肤缺损手术设计方法中的应用效果。方法：采用VSD技术加一期清创二期植皮手术治疗18例。其中单侧下肢完全性脱套伤2例（皮肤软组织缺损面积占体表面积的20%）;单侧小腿辗挫伤7例;大面积压疮3例;单足严重辗挫伤7例;上臂撕脱伤6例。跟踪随访6～12个月,平均9个月。结果：VSD负压封闭引流技术可明显促进肉芽组织生长,经封闭式负压引流10d后,18例患者VSD海绵下内芽组织生长良好,创面无有不周程度的缩小,该方法可防止感染,无局部及全身并发症发生,为二期植皮或者转移皮瓣创造条件。结论：经封闭式负压引流可以促进肉芽组织成长,引流充分,为日后的皮肤再植提供了良好的基础,不影响健康组织的血供,手术简单,疗效可靠,可大大缩短病程。

Application of vacuum sealing drainage (VSD) in operation design of large area skin defect

Objective: To investigate the application of vacuum sealing drainage (VSD) in operation design of large area skin defect. Methods: Took technology of vacuum sealing drainage (VSD) to primary debridement and secondary sealing wounds treating 18 patients. In all patients, two cases were complete trauma of single lower extremity (area of skin defect 20% in the whole body surface area); Seven cases were trauma of single leg; Three cases were large area bedsore; Seven cases were trauma of single foot; Six cases were trauma of single arm; All patients’ track of investigating were followed up for 6 to 12 months, on average of 9 months. Results: The technology of vacuum sealing drainage (VSD) promoted tissue growing of granulation were obviously, during ten days of vacuum sealing drainage (VSD) adsorption, granulation tissue had grown satisfied under the sponge in all patients, wound surface reduced obviously. The method could prevent infection, without any complication, it had provided advantageous requirement for secondary sealing wound. Conclusion: Vacuum sealing drainage (VSD) promotes granulation growing, draw forth completely, providing abundant base for sealing wound in the days to come, no influence healthy tissue of supplying blood, operation is simple and convenient, the trecting effect is reliable, it can shorten the course of treatment.