负压封闭引流技术治疗感染性骨不连伴皮肤软组织缺损

Vacuum sealing drainage for infective nonunion accompanied with soft tissue defect

目的探讨应用负压封闭引流技术(vaccum sealing drainage,VSD)治疗感染性骨不连伴皮肤软组织缺损的疗效。方法 2007年1月～2010年2月,我科采用彻底清创以及VSD技术封闭创面治疗23例感染性骨不愈合伴皮肤软组织缺损患者。7～10 d后拆除VSD装置,对肉芽组织生长丰富且无骨与肌腱外露者行游离植皮,对伴肌腱或骨外露的患者应用组织瓣移位或移植术的方法覆盖创面。结果所有患者术后获8～26个月(平均14.2个月)随访。23例患者经VSD技术治疗1～4次(平均1.3次)后感染得到控制,肉芽生长充分、新鲜,行游离植皮或组织瓣移植,均一次成活。骨折均获骨性愈合,骨折愈合时间8～24个月,平均13.5个月。结论 VSD技术有效控制感染,并能刺激肉芽组织生长,促进创面愈合和毒素排出,为二期手术提供了良好条件,对治疗感染性骨不连伴皮肤软组织缺损具有良好疗效。

[Abstract] Objective To evaluate the efficacy of the vacuum sealing drainage （VSD） for infective nonunion accompanied with soft tissue defect. Methods The clinical data of 23 cases of infective nonunion accompanied with soft tissue defect in our Department from Jan. 2007 to Feb. 2010 were retrospectively analyzed. The wounds were covered with VSD device, and the device was removed 7 to 10 days after operation. Skin grafting was done on the cases without bone or tendon exposure, while the others were given flap transplanting. Results All cases were followed up from 8 to 26 months （mean 14. 2 months）, the inflammation was cured, and the granulation tissues grew well on the surface of wound. The skin grafting and flap transplan- ting were successfully done on the wounds, and the fractures were all cured successfully. Healing time was from 8 to 24 months （mean 13. 5 months）. Conclusion The VSD device can control the inflammation effectively. It can stimulate the growth of granulation tissues and accelerate the healing of wounds, which makes a good condition for the second stage operation VSD appears to be the effective treatment for infective nonunion accompanied with soft tissue defect.