持续封闭负压引流治疗糖尿病合并四肢急性蜂窝织炎的临床疗效观察

The Therapeutic Effect of the Vacuum Sealing Drainage for Diabetes Patients Complicated with Acute Cellulite of Extremities

目的观察持续封闭负压引流(vacuum sealing drainage,VSD)技术在糖尿病合并四肢急性蜂窝织炎的临床疗效。方法 18例糖尿病合并四肢急性蜂窝织炎患者,在全身治疗的同时,蜂窝织炎病灶切开后应用持续封闭负压引流敷料覆盖创面,持续吸引7～10 d后,拆除敷料,如肉芽新鲜,生长旺盛,无脓性分泌物,行二期缝合;如创面分泌物多、新鲜肉芽生长不良,重新更换VSD敷料,继续负压引流,直至肉芽生长良好为止,再行二期缝合。结果 16例患者使用一次VSD治疗后二期缝合伤口愈合,VSD时间为(8.3±1.0)d。2例患者行两次VSD,分别于第二次VSD后7 d和9 d行二期缝合伤口愈合。无一例患者出现VSD的局部及全身反应。结论 VSD治疗方法简单有效,能彻底清除创面的分泌物和坏死组织,刺激肉芽生长,快速控制感染,明显缩短治疗时间,减轻换药痛苦,减轻医护人员的工作量,值得临床推广应用。

Objective To investigate the clinical effect of the vacuum sealing drainage（VSD） in acute cellulite of extremities in diabetes patients.Methods 18 diabetes patients with acute cellulite of extremities received VSD after surgical incision of the lesion.After continuous negative pressure drainage for 7~10 days,the dressings were removed off.If the granulation was fresh with vigorous growth,then the second stage sutures were followed.If the fresh granulation was poor growth with much wound secretion,then the VSD dressing was replaced for continued negative pressure drainage until the growth of granulation was good for the two stage sutures.Results 16 patients healed with（8.3±1.0） days VSD treatment and a secondary suture.And 2 patients healed with 7 days and 9 days twice VSD treatment and a secondary suture respectively.No VSD relative local or systematic reaction was observed.Conclusions It is proved to be simple and effective of the VSD,which can clean the wound completely,stimulate the growth of acestoma,control the infection,shorten the treatment time and alleviate the sufferings of patients.It is worthy to be popular in the clinical use for the acute cellulite of extremities in diabetes patients.