VSD灌洗联合带蒂非主干血管皮瓣移植治疗足踝部感染性组织缺损疗效分析

Treatment of the infectious wounds of foot and ankle by VSD irrigation combined with transplantation of non-main vessel pedicle skin flap

目的探讨应用VSD灌洗联合带蒂非主干血管皮瓣移植治疗足踝部感染性组织缺损的疗效。方法自2009年以来,我院应用VSD灌洗联合带蒂非主干血管皮瓣移植治疗足踝部感染性组织缺损30例,治疗方法:①术前根据药敏结果全身应用敏感抗生素治疗;②术中彻底清创,清除坏死骨组织及炎性肉芽组织;③创面安置VSD负压材料,持续抗生素灌洗5～7d,负压封闭引流8～10d;④应用局部皮瓣转移修复足踝部创面。结果本组30例均获得随访,随访时间8个月,感染均已控制,感染部位达到临床愈合。结论采用一期VSD联合敏感抗生素冲洗,二期采用带蒂非主干血管皮瓣修复组织缺损,可彻底治愈足踝部感染性创面。

Objective To evaluate the clinical efficacy in the treatment of infectious wounds of foot and ankle by VSD irrigation and transplantation of non-main vessel pedicle skin flap. Methods Collected 30 patients and performed VSD irriga- tion combined with skin flap grafting since 2009. Treatment ：（1）Selected sensitive antibiotics based on the resuh of bacteria culture and drug sensitivity test. （2）All cases were given radical debridement during operation by removing the necrotic bone tissue and granulation tissue. （3）The wounds were covered with VSD negative pressure drainage equipment, continuous antibiotic lavage for 5-7 days and VSD negative pressure drainage for 8-10 days. （4）The wounds of ankle and foot were treated with local flap. Results After 8 months follow-up, all cases were obtained clinical healing. Conclusion Performing VSD in the first stage, and non-main vessel pedicle skin flap grafting in the second stage, can completely cure the infectious wounds of foot and ankle.