负压封闭引流技术与吸附材料在大面积皮肤撕脱中的应用

Effect of vacuum sealing drainage and adsorbing material on treatment of large area of skin avulsion wound

背景:在临床中,大面积皮肤撕脱伤的患者由于皮瓣血运差,严重感染等原因,皮瓣回植效果欠理想,常需经反复换药。以往该方面的研究相对较少。目的:观察负压封闭引流技术与吸附材料在大面积皮肤撕脱伤中的应用效果。方法:回顾性分析2008-09-01/2009-08-31邢台医学高等专科学校附属医院医学美容科收治的大面积皮肤撕脱伤患者100例,损伤面积介于10%～50%不等,按患者入院时间分为两组,单日收治的患者为试验组(n=58):采用负压封闭引流技术治疗;双日收治的大面积皮肤撕脱伤患者为对照组(n=42):采用普通换药方法治疗,其他治疗一致。比较两组患者住院时间、感染率与治愈情况等。结果与结论:试验组患者住院时间较对照组缩短,差异具有显著性意义(P<0.05)。试验组中2例患者有鲍曼不动杆菌感染,4例绿脓杆菌感染,感染率10%;对照组有7例绿脓杆菌感染,5例MRSA感染,感染率29%。试验组感染例数明显低于对照组(P<0.05)。试验组中,一期愈合患者46例(79%),其他12例(21%)采用自体游离皮移植修复;对照组中回植后,一期愈合患者12例,其他30例均于肉芽组织长出后清创植自体皮术愈合。二期手术时间试验组较对照组短,差异有显著性意义(P<0.05)。提示负压封闭引流技术与吸附材料在大面积皮肤撕脱中应用效果满意。

BACKGROUND：Skin flap replantation was poor in patients with large area of skin avulsion due to poor blood transportation and severe infection;therefore,dressing should be changed again and again.OBJECTIVE：To investigate the effect of vacuum sealing drainage technology and absorbing materials on the large area of skin avulsion.METHODS：A total of 100 patients with large area of skin avulsion were selected from Department of Medical Beauty of Affiliated Hospital of Xingtai Medical College between September 1,2008 and August 31,2009.The injury area ranged from 10% to 50%.All patients were randomly divided into odd day group（n=58,testing group which was treated with vacuum sealing drainage）and even day group（n=42,control group which was treated with dressing treatment）.Length of stay,infection rates and healing were compared between the two groups.RESULTS AND CONCLUSION：Length of stay in the testing group was significantly shorter than control group（P0.05）.In the testing group,two cases had baumanii infection and 4 had pseudomonas aeruginosa infection,and the infection rate was 10%.In the control group,7 cases had pseudomonas aeruginosa infection and 5 had MRSA infection,and the infection rate was 29%.The infection rate in the testing group was significantly lower than control group（P0.05）.In the testing group,46 patients（79%） were cured in the first therapy cycle,and the other 12 cases（21%）were treated with autoallergic free skin transplantation;in the control group,12 cases were cured in the first therapy cycle,and the other 30 patients were treated with autoallergic skin transplantation following granulation tissue growing.The secondary operation time in the testing group was significantly shorter than control group（P0.05）.The results suggested that the effect of vacuum sealing drainage technology and absorption materials application were satisfactory in a large area of skin avulsion.