四肢皮肤严重撕脱伤回植术中持续应用VDS治疗效果

The treatment efficacy of continuous VDS use in replantation in the treatment of severe skin avulsion injury of Limbs

目的探讨四肢皮肤严重撕脱伤回植术中持续应用负压封闭引流技术(VDS)治疗效果分析。方法选取2011年5月至2015年11月我院收治四肢皮肤严重撕脱伤患者58例分为研究组和对照组,对照组采用常规清创换药后Ⅱ期植皮,研究组回植术后持续应用VDS治疗,比较两组患者皮片存活率、换药次数、住院时间、住院费用及并发症发生情况。结果研究组患者首次植皮存活率高于对照组(100.00%vs.75.86%,P<0.05);研究组患者感染、下肢深静脉血栓形成、淋巴水肿并发症发生率低于对照组(17.24%vs.48.28%,3.45%vs.20.69%,0.00%vs.17.24%,P<0.05)。研究组患者换药次数、住院时间及住院费用均少于对照组[(4.2±0.6)次vs.(17.9±3.5)次,(15.4±3.1)d vs.(34.8±5.4)d,(10214.5±2354.1)元vs.(18987.5±3256.4)元,P<0.05]。结论四肢皮肤严重撕脱伤回植术中应用VDS治疗可有效提高植皮成功率、降低并发症,缩短患者治疗时间,减轻患者经济负担。

Objective To investigate the therapeutic effect of continuous applied of VSD technology in replantation for the treatment of analysis severe skin avulsion of limbs. Methods Select 58 cases of patients with severe skin avulsion of limbs,they were admitted to department of Burns and Plastic Surgery during May 2011 and November 2015,randomly divide them to study group and control group. Patients in the control group adopted conventional debridement and dressing and then received phase II skin grafting. However,patients in study group adopted replantation and continuous application of VDS for treatment. Survival of skin graft,number of dressing changes,length of stay,hospital costs and complications of the two groups were compared. Results First time Graft survival rate in study group was higher [100. 00% Vs 75. 86%,P〈0. 05]. The incidence infection,deep venous thrombosis and lymph edema of study group were less than that in the control group [17. 24% Vs 48.28%,3. 45% Vs 20. 69%,0. 00% Vs 17. 24%,P〈0. 05]. Number of dressing changes,hospital stay and hospital costs of study were less than the control group [（ 4. 2 ± 0. 6） times Vs（ 17. 9 ± 3. 5） times,（ 15. 4 ±3. 1） d Vs（ 34. 8 ± 5. 4） d,（ 10214. 5 ± 2354. 1） Yuan Vs（ 18987. 5 ± 3256. 4） Yuan,P〈0. 05].Conclusions The application of VDS in replantation for the treatment of severe skin avulsion of Limbs can effectively improve the skin graft success rate and reduce complications,shorten patient treatment time,reduce the economic burden of patients.