负压封闭引流技术在肢体创面应用中若干问题的研究

目的 分析并采取措施减少和负压封闭引流技术相关的并发症,使其在肢体创面的应用中更加成熟. 方法 回顾320例肢体创面的负压封闭引流疗效,统计并发症的发生率、分析产生并发症的原因、采取相应解决办法;且对四种常用封闭膜的效果进行比较. 结果 引流通路阻塞309例(96.6%),为最多见并发症,应用通管技术可以有效解决和预防;创面负压不够62例(19.4%),轮替夹闭部分管道可以解决.四种封闭膜中以"透明辅料"特性最好,以"外科手术膜"最为实用.严重创面36例,使用负压封闭引流技术1～2次后适合植皮或皮瓣术者35例(97.2%).结论 使用负压封闭引流技术后仍要勤观察,及时采取措施来减少并发症.该技术在严重创面的治疗中最能彰显优势.

Vacuum sealing drainage for limb wounds:complications and countermeasures

Objective To evaluate vacuum sealing drainage (VSD) in limb wound care for better countermeasures against its related complications. Methods A retrospective study was done to analyze the outcome of 320 cases of VSD.The related complications,causes and countermeasures were statistically analyzed.The clinical effects Of 4 kinds of commonly used sealing membranes were cornpared. Results The block of drainage passage occurred in 309 cases(96.6%),being the commonest complication,for which the reopening technique was a good solution and precaution.Negative pressure sufficiency was found in 62 cases(19.4%)and could be resolved by alternative closing of partial drainage tubes.Of the 4 widely used sealing membranes,Tegaderm Transparent Dressing had the best clinical effect,but Surgical Adhesive Drape proved to be the most practicable in China.Of the 36 cases of serious wounds,35(97.2%)healed and their wound condition was ready for further skin graft or flap surgery after 2 times of VSD. Conclusions VSD works best in care of serious wounds,but it requires frequent observations and timely measures to minimize occurrence of complications.