原位植皮+负压封闭引流技术治疗肢体大面积皮肤撕脱伤的疗效分析

Vacuum Sealing Drainage combined with in-situ Graft in Treating Large-area Skin Avulsion Injury

目的：探讨原位植皮＋负压封闭引流技术（vacuum sealing drainage,VSD）在治疗肢体大面积皮肤撕脱伤中的作用及效果。方法：对2006年3月~2010年3月我院收治的57例肢体大面积皮肤撕脱伤患者行一期清创原位植皮＋VSD封闭引流的方法进行治疗。将2000年3月~2004年3月采用常规原位植皮打包换药治疗的69例肢体大面积皮肤撕脱伤患者作为对照组。结果：负压封闭治疗组57例患者术后无1例发生创面感染,植皮存活面积90~98%。愈合时间、换药次数、住院天数均明显低于对照组。结论：肢体大面积皮肤撕脱伤是一种严重创伤,处置不当容易并发感染、皮肤坏死等严重并发症,原位植皮＋负压封闭引流技术的治疗方法可明显提高皮肤存活率及降低感染率,缩短治疗周期,减轻患者痛苦。

Objective：To investigate the clinical effect of vacuum sealing drainage（VSD） combined with in-situ graft on large-area skin avulsion injury.Methods： From March 2006 to March 2010,57 patients with large-area skin avulsion injury were treated in our hospital.After the debridement,the in-situ graft was covered with the VSD system.Another 69 patients from March 2000 to March 2004 with large-area skin avulsion injury who were treated with routine in-situ graft combined with dressing changed served as controls.Results： After the treatments,no patient had severe local tissue necrosis or infection.The skin survival area of the cases was 90%~98%.The healing time,frequency of dressing change,and hospital days were remarkably shorter than those in controls.Conclusion：VSD combined with in-situ graft can promote survival rate,shorten healing time,and alleviate the pain in patients,so it is a simple and effective method in treatment of large-area skin avulsion injury.