超声清创系统结合负压创面疗法在骨外露创面中的应用

Application of ultrasonic debridement system conbined with negative pressure wound therapy in bone-exposed wounds

目的研究超声清创系统结合负压创面疗法治疗骨外露创面的临床效果。方法采用超声手术系统结合负压创面疗法治疗17例患者,共18个骨外露创面,骨外露创面面积平均(10.5±6.6)cm2。观察坏死骨组织清除速度、清除效果,清创术后3周创面愈合率,植皮成活率,创面完全愈合时间。结果超声清创系统可以快速而有效地清除坏死骨组织以及磨除骨皮质。清创术后3周创面愈合(62.3±25.1)%,未愈合创面肉芽组织长满创面,色鲜红。植皮全部成活率88.9%,从第一次清创至创面完全愈合时间为(28.1±9.1)d。结论超声清创系统结合负压创面疗法治疗骨外露创面可有效清除坏死骨组织,促进肉芽组织迅速生长,缩小创面面积,从而加速创面愈合,是治疗骨外露创面的一种行之有效的方法。

Objective To study the treatment effects of ultrasonic debridement system conbined with negative pressure wound therapy on bone-exposed wounds. Methods Seventeen patients including 18 bone-exposed wounds received the treatment of ultrasonic debridement system combined with negative pressure wound therapy. The average wound area was （10.5 ± 6.6） cm^2. Effects of ultrasonic debridement system on bone, rate of change in wound area, skin graft survival rate, time to complete healing were determined. Results Ultrasonic debridement system could effectively and precisely remove the necrosis bone tissue and cortical bone. Three weeks after debridement and negative pressure wound therapy, wound healing rate was （62.3 ±25.1 ） %, and wounds that were not healed were filled with fresh granulation tissue. Skin graft survival rate was 88.9%. Time to complete healing was （28.1 ±9.1 ） days. Conclusions Ultrasonic debridement system combined with negative pressure wound therapy can effectively and precisely remove the bone tissue, improve the growth of granulation tissue, and reduce the wound area. it is a better way to deal with the bone-exposed wounds.