负压吸引在老年肢体深烧伤植皮区的应用

Application of Vacuum Sealing Drainage with Continuous Negative Pressure on the Skin-grafting Wounds of Limbs with Depth Burns of Olds

目的了解负压吸引(VSD)对老年肢体深烧伤清创植皮区皮片生长愈合的影响。方法观察组选老年肢体深烧伤7例,11个肢体,常规手术清创自体刃厚皮片移植后应用VSD持续吸引,维持负压-0.15～-0.25kPa之间,7～14d,7d更换一次至术后14d拆除VSD装置,对照组选老年肢体深烧伤18例,21个肢体,植皮手术后常规包扎换药,术后48h,7、14d观察2组的创面渗出、愈合时间、植皮片存活率、手术次数。结果观察组的术后创面渗血渗液发生率低,与对照组比较有显著差异(P<0.01),表明炎症反应轻,植皮片更易完全存活,创面愈合时间短,平均(11±4)d,对照组则愈合时间平均(18±11)d,且所有患者均不需再次手术,肢体功能恢复好,遗留瘢痕少。结论清创植皮术结合持续VSD在老年肢体深烧伤植皮伤口应用,有利于促进植皮存活,促进创面愈合,减少瘢痕形成,恢复肢体功能。

Objective To study the influence of application of negative-pressure on the skin-grafting wounds of limbs for treatment old depth burns.Methods 11 skin-grafting wounds of 7 patients with depth burn limbs used vacuum sealing drainage with negative-pressure after accepted debridement and skin graft.Wounds of patients in negative-pressure were treated interrupted suction under a pressure of-0.15～-0.25 kPa for 7 d.Than replace the vsd continuous suction of the same negative-pressure for another 7 d,a postoperative 14 d dismantled to attract device.Older members choose deep burn in the control group,18 cases,21 members,conventional postoperative bandage.The two groups of patients postoperative 48 h,7 d,14 d observed wound effusion,healing time of skin graft survival,times of operation.Results The observation group of postoperative wound errhysis and inflammation exudates low incidence,compared with controls have significant difference（P0.01）,show that little inflammatory reaction and the skin graft survival of more completely,coagulant short time,the average（11±4）days,and the control group is an average of（18±11）days healing time,and all of the patients need not reoperation,limb function recovered well,left little scar.Conclusions Debridement and skin-grafting wounds combined with vsd negative-pressure is satisfactory for the treatment depth burn limbs wounds of old,and it can promote sheet of skin-grafting survival rate,short the times of treatment,less scar leaved,promote restore function of wound limbs.