封闭负压引流技术对慢性创面愈合影响及应用时机

Effect of vacuum sealing drainage on chronic wound healing and its application time

目的探讨封闭负压引流技术(VSD)对慢性创面愈合的影响及最佳应用时间。方法选取北部战区总医院自2018年6月至2019年6月收治的20例准备通过游离植皮与皮瓣转移修复慢性创面的患者为研究对象,组织块样本取材于VSD负压治疗前和治疗后第5~7、10~12天的创缘或基底肉芽组织。观察3个时间点的慢性创面愈合及血管密度变化情况。结果 20例患者均完成观察。在VSD负压治疗后第5~7、10~12天,创面血管密度均较治疗前增加,且以治疗后第5~7天血管密度最高,差异有统计学意义(P<0.05)。VSD后行单纯游离植皮患者8例、皮瓣转移患者6例、皮瓣转移结合游离植皮患者6例,患者均于创面达到乙级愈合后出院。结论 VSD治疗慢性创面的最佳时间段为第5~7天,在这个时间段内,VSD治疗可使创面由病理性愈合向生理性愈合转化,便于后续治疗。

Objective To investigate the effect of vacuum sealing drainage(VSD)on chronic wound healing and its optimal application time.Methods A retrospective study was performed on 20 cases of patients who were prepared to be repaired chronic wound surface by free skin grafting and flap transfer from June 2018 to June 2019.Tissue samples were obtained from marginal or basal granulation tissue before,5-7 days and 10-12 days after negative pressure treatment of VSD.Chronic wound healing and vascular density changes were observed at three time points.Results All 20 patients were observed.On days 5-7 and 10-12 after VSD negative pressure treatment,the vascular density on the wound increased compared with that before treatment,and the vascular density was the highest on days 5-7 after treatment,and the difference was statistically significant(P<0.05).After VSD,8 patients were treated with free skin grafting alone,6 with flap transfer,and 6 with flap transfer combined with free skin grafting.All the patients were discharged after the wound surface reached Grade B healing.Conclusion The best time period for the treatment of chronic wound by VSD is the 5 th-7 th day.In this time period,the treatment of VSD can transform the wound from pathological healing to physiological healing,facilitating the follow-up treatment.