封闭负压吸引在创伤性胫骨骨外露的应用

目的探讨封闭负压吸引在创伤性胫骨骨外露中的疗效。方法 45例创伤性胫骨骨外露（Ⅰ～Ⅳ度）患者清创后测量骨外露面积,将VSD材料按创面面积大小和形态剪裁并将其创面与周围正常组织间断缝合固定,引流管连接负压吸引装置,维持负压40 kPa;7 d后对外露骨质表面处理,再次使用负压吸引材料覆盖。结果 22例Ⅰ、Ⅱ度骨外露者7 d后骨外露全部被新鲜肉芽组织覆盖;15例Ⅲ度骨外露者7 d后骨外露存在,面积减小,对外露骨质表面处理后再次使用封闭负压吸引材料覆盖,骨外露全部被新鲜肉芽组织覆盖;8例Ⅳ度骨外露者使用封闭负压吸引治疗后骨外露不能完全被肉芽组织覆盖,但骨外露面积明显缩小,使用组织皮瓣转移覆盖骨外露。结论封闭负压吸引对面积〈5 cm2的胫骨骨外露能够有效促进肉芽组织生长,并将其完全覆盖。对于〉5 cm2的胫骨骨外露使用封闭负压吸引后能够为组织皮瓣移植创造良好的创面。

The application of vacuum sealing drainage in the treatment of traumatic tibial bone exposure

Objective To explore the effect of vacuum sealing drainage in the treatment of traumatic tibial bone exposure. Methods 45 cases of traumatic tibial bone exposure （ I - IV degree） were measured after debridement of the exposed bone area. The VSD was eu! to the wound size and sutured to the wound. The drainage was keep in -40 kPa. After 7 d,the wound was debrided and covered by VSD again. Results I , Ⅱ degree of bone exposure in 22 patlenls got granulous tissue covered after 7 d. Ⅳ degree of bone exposure in 15 cases decreased after there 7 d and all exposed bone was covered by granulation tissue after re-use of VSI）. IV degree of bone exposure in 8 patients treated with VSI） did not got completely cover by granulation tissue, but the exposed bone area was significantly reduced, amt the remained exposed bone was covered by flaps. Conclusions VSD on the area of 〈 5 em^2 of the tibia bone exposure can effeclively pronm!e the growth of granulation tissue to full coverage. For 〉 5 em2 of the tibia bone exposure, VSD can provide a good wound for flap coverage.