封闭负压技术治疗各种术后伤口裂开

Vacuum assisted closure technique for treating postoperative wound dehiscences

目的:观察封闭负压技术治疗外科手术后伤口裂开的临床效果及总结应用经验。方法:从2007年5月至2009年12月,采用封闭负压技术治疗各类外科术后伤口裂开患者17例,其中男10例,女7例,平均年龄41岁。创面面积为0.5cm×3.2cm～5.5cm×18.6cm,创面形成时间为8～94天,期间采用常规湿敷或中药换药治疗伤口未愈。给予-120mmHg～-150mmHg负压持续吸引,治疗时间为6～37天。结果:10例经封闭负压治疗后创面直接愈合,其余7例创面清洁,肉芽组织新鲜,伤口缩小,4例清创缝合,2例行局部皮瓣转移,1例行皮片移植修复,伤口均一期愈合。术后随访2～12个月,所有伤口愈合良好,无再次裂开。结论:封闭负压技术简便、无创,能有效促进伤口清洁,加快肉芽组织生长,缩短创面愈合时间,适合治疗各种外科术后伤口裂开,有较高的临床推广应用价值。

Objective To summarize the methods and clinical effect of treating postoperative wound dehiscences with Vacuum Assisted Closure（VAC） technique.Methods From May 2007 to December 2009,VAC was employed to treat 17 patients with wound dehiscences after operation that could not be closed immediately,including 10 males and 7 females with a mean age of 41 years old.The size of the wounds ranged from 0.5cm×3.2cm to 5.5cm×18.6cm,and all the wounds had been managed using saline-soaked gauze dressings or the traditional Chinese medicine for 8 to 94 days with no signs of healing.VAC was maintained on a continuous mode with a negative pressure of-120mmHg to 150mmHg.The wounds had been treated for 6 days to 37 days.Results Ten of the 17 wounds achieved healing directly after VAC therapy.Seven other wounds developed healthy granulation tissue and contracted size.Stable cutaneous coverage were achieved by surgical debridment and suture,local skin flap transplantation,or skin grafting.All the cases were followed up for 2 months to 12 months.No infection or reopening of the wounds were observed.Conclusions VAC technique is simple,noninvasive and effective in keeping wound clean,promoting growth of granulation tissue and accelerating wound closure.So it deserves to be popularized for treating a variety of wound dehiscences.