负压封闭引流术在骨科大面积创伤中的应用体会

Application of vacuum sealing drainage in the treatment of skin and soft tissue defect of extremities

目的探讨负压封闭引流术(VSD)在治疗四肢皮肤大面积软组织损伤中的作用。方法应用VSD治疗大面积皮肤及软组织损伤患者29例,均先根据损伤控制理论处理合并伤,平稳后清创,再应用VSD 5～10d,根据创面肉芽组织生长情况更换引流装置。创面有新鲜肉芽组织后,行皮片植皮或缝合修复创面。结果经过负压封闭引流,所有患者体温、血象正常,伤口局部无窦道,无感染,创面均被新鲜肉芽组织填充,经植皮修复全部愈合。结论 VSD是治疗骨科大面积软组织损伤的一种有效方法,愈后好,并发症少。

Objective To investigate the effect of vacuum sealing drainage（VSD） in the skin and soft tissue defect of extremities.Methods 29 patients of the skin and soft tissue defect of extremities were treated with VSD.All cases were given debridement after management of associated injury according to damage control procedure.Drainage changes were given every 5～10 days according to the drainage state.When fresh granulation tissue emerged in the trauma area,all defects were undergone skin graft or suture to cover the trauma surface.Results The 29 cases showed no trauma surface infection after debridement and subsequent vacuum drainage.All patients were normal in body temperature and blood routine test,without local fistula,fresh granulation tissue emerged in the trauma area,skin graft or suture covered the trauma surface.Conclusions VSD has superiority in curing the skin and soft tissue defect of extremities.