持续负压封闭引流对急性软组织创伤炎症反应的影响研究

目的探讨持续负压封闭引流技术对急性软组织创伤后炎症反应的影响。方法将4｜D例各种原因所致的急性创伤的患者分为A组20例（治疗组）、B组20例（对照组）。A组常规创面清创后利用持续封闭式负压引流覆盖创面；B组常规对创面进行清创生物敷料A覆盖后包扎换药。伤后、术前及术后1d、3d、5d分别抽静脉血留取血清血，检测血清中肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、白细胞介素-8（IL-8）的含量。7d后两组患者按照创面情况选用不同手术方式治疗修复创面（骨外露或者肌腱等外露皮瓣修复创面，其余采取游离皮移植修复）。结果两组患者血清中TNF-α、IL-6、IL-8的含量检测结果表明，术前两组无明显差异（P〉0．05），术后1d、3d、5d，A组各项指标含量在各时段明显低于B组，差异有统计学意义（P〈0．05）。A组创面修复愈合平均时间明显短于B组，差异有统计学意义（P〈0．05）。结论急性软组织创伤创面使用持续负压封闭引流技术可以有效减轻创伤炎症反应，利于创面愈合。

Application of continuous vacuum sealing drainage technique in the prevention of wound infection in acute soft tissue trauma

Objective To study the effect of continuous vacuum sealing drainage （VSD） technique in the prevention of inflammatory reaction in acute soft-tissue trauma. Methods Forty cases of acute traumatic wounds caused by various reasons were randomly divided into two groups. Twenty cases were treated by coveting wounds with continuous VSD after general wound debridement （ treatment group, group A） and the other 20 eases were treated by regular debridement of the wound followed by coveting biological dressing A（ control group, group B ）. The blood ser- um was taken by phlebotomizing to detect the content of TNF-α, IL-6 and IL-8 on preoperative and postoperative day 1,3,5. The swelling degree of postoperative wound was observed. According to the condition of wounds patients in tow groups were chosen different surgical methods for wound repair 7 days later. Results There was no significant differ- ence about the content of TNF-α, IL-6 and IL-8 between the two group on preoperative day（ P 〉 0. 05 ）. On postopera- tive day 1,3,5, the content of TNF-α,IL-6, and IL-8 in group A was significantly lower than that in group B （P 〈 0. 05 ）. The average time of wound healing in group A was significantly shorter than that in group B （ P 〈 0.05 ）. Con- clusion Using continuous VSD technique in acute soft tissue trauma can reduce the inflammation and facilitate wound healing.