封闭式负压引流术治疗外科慢性体表溃疡的临床观察

Vacuum-assisted closure in the treatment of surgical chronic ulcers on body surface

目的:了解封闭式负压引流术(VAC)治疗外科慢性体表溃疡的疗效。方法:回顾性分析运用VAC治疗的36例外科慢性体表溃疡患者的临床资料。结果:36例患者分别为糖尿病慢性溃疡11例(30.6%)、深部褥疮9例(25.0%)、静脉炎8例(22.2%)、糖尿病并发静脉炎4例(11.1%)和痛风4例(11.1%)。创面范围4 cm×5 cm～12 cm×15 cm,大部分深达骨面。均未用抗生素或人体蛋白治疗。36例均治愈,其中经VAC治疗后直接愈合19例,创面缩小后缝合治愈10例,创面缩小后植皮7例。治疗时间为14～49 d,平均22.6 d。随访3个月,均无复发。结论:VAC对外科慢性体表溃疡的治疗疗效令人满意。

Objective： To elucidate the efficacy of vacuum-assisted closure （ VAC ） in the treatment of surgical chronic ulcers on body surface. Methods： Clinical data of 36 patients with surgical chronic ulcers on body surface treated by VAC were analyzed retrospectively. Results： The ulcers of 36 cases were caused by diabetes mellitus （11 cases, 30. 6% ）, deep decubitus （9 cases, 25.0% ）, phlebitis （8 cases, 22. 2% ）, diabetes mellitus compli- cated with phlebitis （4 cases, 11.1% ） and gout （4 cases, 11.1% ）. The wound surface ranged from 4 cm × 5 cm to 12 cm × 15 cm. A majority of these ulcers reached the bone surface. All the patients underwent VAC therapy were cured without antibiotics or human proteins treatment, among whom 19 cases were directly healed, 10 were sutured after VAC and 7 received dermatoplasty after VAC. The healing time ranged from 14 to 49 days with a mean time of 22.6 days. All the patients followed-up for 3 months and no recurrence was found. Conclusion： The efficacy of VAC in the treatment of surgical chronic ulcers is satisfactory.