VSD技术在下肢大面积皮肤撕脱伤的应用研究

TREATMENT OF LARGE AVULSION INJURY OF SKIN AT LOWER LIMBS BY REATTACHMENT OF SKIN COMBINED WITH VACUUM SEALING DRAINAGE

目的探讨负压封闭引流技术（Vacaum staling drainage，VSD）治疗下肢大面积皮肤撕脱伤的临床效果。方法对23例下肢大面积皮肤撕脱伤患者应用VSD技术开展治疗观察。结果平均使用VSD7d，然后游离植皮，23例皮片全部存活（创面愈合），5例皮片存活面积达95％～98％，经换药后，创面愈合，患肢运动功能及外观恢复良好。与对照组比较，在平均住院天数、植皮的愈合率、换药次数及总费用等方面差异均有统计学意义（P〈0．05）。结论VSD结合游离植皮处理下肢皮肤撕脱创面能在Ⅰ期关闭创面的同时，更好地进行创面引流，促进创面的良好贴附，有利于皮片存活，是治疗下肢皮肤撕脱伤较好的处理方法。

Objective To investigate the treatment effects of reattachment of skin combined with vacuum sealing drainage （VSD） on large avulsion injury of skin at lower limb. Methods 23 cases of large avulsion injury of skin at lower limb treated with vacuum sealing drainage and the effectiveness of this therapy was observed. The sur- face of polyvinyl alcohol with more than gelatin sponge cover closed, 24 h continuous suction （ negative pressure is maintained at - 40 - - 60 kPa between） Results The average time of VSD therapy was 7 days. Then the patients were carried out the free flap transplantation. 23 cases recovered completely, the flap survival rate in 5 cases was 95 -98%. The mean administration days, the curing rates of grafts and cost were shown statistics deference（ P 〈 0.05 ） Conclusion The large avulsion injury of skin at lower limbs can be closed by free flap transplantation with VSD, which is a creditable treatment for limbs skin - tear wound.