简易负压封闭引流治疗下肢严重感染性创面的效果观察

Observation on the effect of self-made vacuum-sealing drainage device in treatment of lower extremity wound with severe infection

目的:探讨自制负压封闭引流装置治疗下肢严重感染性创面的效果。方法:对35例下肢严重感染并有软组织缺损的患者采用自制的封闭式负压吸引装置(由无菌高分子泡沫海绵、手术用无菌贴膜、医用硅胶管、墙壁式负压引流装置组成)治疗,压力-75～-100 mmHg,每48～72 h更换负压装置,并在每次更换负压装置时进行清创。根据创面清洁度及新鲜肉芽生长情况择期行二期游离植皮或皮瓣转移修复术。结果:35例患者经过负压封闭引流10～63 d(平均18 d)治疗后创面清洁,面积较前缩小,肉芽生长新鲜,游离皮片移植或皮瓣转移修复创面均一次性获得成功;且耗材费用(20～50元/次)较进口成套负压封闭引流装置(1000～3000元/次)低廉。结论:自制封闭式负压引流装置结合间断清创能够有效地控制创面感染,促进坏死物脱落,加速愈合,为组织移植、创面修复创造条件;且费用低廉,易于推广。

Objective： To investigate the effect of the self-made vacuum-sealing drainage device in treating lower extremity wound with severe infection. Methods： Thirty-five patients who suffered severe infection of extremity wounds and soft tissue defects received vacuum-sealing drainage treatment with the self-made device, which consisted of high molecular polymer foam sponge, sterile plastic membrane for operation, medical silica gel tube, and negative pressure suction equipment. The pressure for treatment ranged from -75 mmHg to -100 mmHg, and the dressings for vacuum-sealing drainage was changed every 48-72 hours. Debridement was carried out during the time of changing dressings. The wounds were finally covered with skin grafts or flaps according to the condition of the wound. Results： All the patients wounds became cleaner and smaller than before after 10-63 days （average 18 days） of treatment, and granulation tissue appeared fresh, and skin grafting or skin flap transplantation was successful. The cost of treatment with self-made vacuum-sealing drainage device was lower （20-50 yuan each time） than the imported one （1 000-3 000 yuan each time）. Conclusion： The self-made vacuum-sealing drainage device combined with debridement can control the infection, promote the separation of necrotic tissues, promote the healing of the wound, reduce the contamination of wound surface and stimulate the growth of fresh granulation tissue. Furthermore, it can be widely used because of its cheaper cost.