VSD联合带蒂皮瓣转移及外支架治疗小腿高能量损伤

The Vacuum sealing dralinge(VSD) union construction of vagina by pedicled skin grafting and external fixation treatment of calf injury of high-energy

目的:总结封闭式负压引流(Vacuum Sealing drainge,VSD)联合带血管蒂皮瓣转移及外固定支架治疗小腿高能量损伤的临床疗效。方法:7例小腿高能量损伤患者,采用早期清创VSD封闭创面,外固定支架结合有限内固定对骨折进行固定,待创面肉芽组织新鲜,感染控制后,用邻近带血管蒂皮瓣转移二期修复创面。结果:7例患者皮瓣全部成活。术后患者均获随访,随访时间4个月～2年,皮瓣外形满意。3例患者发生钉道感染,1例骨感染病例发生骨延迟愈合,7个月后拆除外固定支架,1例骨缺损患者行骨节段移位1年后拆除支架。结论:VSD联合带蒂皮瓣转移及外固定支架技术,治疗小腿高能量损伤是一种安全有效的方法。

Objective： Summarize the clinical efficacy of Vacuum sealing dralinge（VSD） union construction of vagina by pedicled skin grafting and external fixation treatment of calf injury of high-energy. Methods：7 cases calf injury of high-energy,by early used debridement and VSD wound closure,used external fixation and limited internal fixation fixed fracture,stay the granulation tissue to be fresh,the infection was controlled,used neighbouring construction of vagina by pedicled skin grafting two-stage wound was closed. Results：All flaps survived completely.All cases were followed -up from 4 months to 2 years,the flaps had satisfactory outline.3 suffered from infection of nail road,the bone delayed union by the infection of bone in one case;removed external fixation after 7 months;removed external fixation after 1 year for the bone segment displacement. Conclusion：The Vacuum sealing dralinge （VSD） union construction of vagina by pedicled skin grafting and external fixation treatment of calf injury of high-energy is a safe and effective method.