基于生物材料创面敷料封闭负压引流在骨筋膜室综合征切开减压中的应用

Application of vacuum-sealing drainage based on biomaterial wound surface dressing in incision decompression of osteofascial compartment syndrome

背景:骨筋膜室综合征切开减压后往往出现肌肉膨出体外、大量组织液渗出导致肌肉创面不新鲜、易发生感染等不利于患者恢复,应用封闭负压引流可以保护创面,避免局部毒素入血。目的:观察基于自主研发的生物材料创面敷料封闭负压引流在骨筋膜室综合征切开后的临床疗效。方法:发生骨筋膜室综合征患者切开减压后采取自愿的原则,给予基于自主研发生物材料创面敷料封闭负压引流、合成材料创面敷料封闭负压引流和常规切开减压敷料包扎治疗。观察治疗后3d患者肝肾功能指标及肉芽颗粒的新鲜度。结果与结论:采用自主研发生物材料创面敷料、合成材料创面敷料封闭负压引流后均能明显保护患者的肝肾功能,肉芽组织颗粒的新鲜度为满意,优于常规切开减压敷料包扎组(P<0.05)。采用合成材料创面敷料封闭负压引流组打开封闭负压时部分患者出现周围区域水泡。提示自主研发新型生物材料创面敷料能有效引流,避免患者毒素入血保护肝肾功能,同时肉芽组织颗粒的新鲜度满意,可为后期植皮提供良好的组织创面,并且具有良好的生物相容性。

BACKGROUND： Muscle bulging in vitro, stale bone wounds caused by a large number of tissue fluid exudation and high incidence of infection often appear after incision decompression of osteofascial compartment syndrome, and these are not conducive to patient recovery. Vacuum-sealing drainage （VSD） can protect the wound and avoid local toxins to enter into the blood. OBJECTIVE： To study the curative effect of VSD based on biomaterial wound surface dressing on incision decompression of osteofascial compartment syndrome. METHODS： Osteofascial compartment syndrome patients received incision decompression were divided into three groups by their wishes： VSD based on biomaterial wound dressing group, VSD based on synthetic wound dressing group and routine pressure dressing group. Indexes of liver and kidney functions and freshness of granulation particles were observed in all patients after 3 days of treatment. RESULTS AND CONCLUSION： The technique of VSD could significantly protect liver and kidney functions, and the freshness of granulation particles in the VSD groups were better compared with the routine pressure dressing group （P 0.05）. Blisters around the wound could be seen in partial patients of the VSD based on synthetic wound dressing group during drainage. It is indicated that VSD based on the new biomaterial wound dressing can effectively drainage, protect liver and kidney functions by avoid toxins entering into the blood, and have a satisfactory freshness of granulation particles. It can provide a good wound surface for later skin grafting and have a good biocompatibility.