基于生物材料创面敷料封闭负压引流在四肢毁损伤治疗中的应用

Application of vacuum-sealing drainage based on biomaterial wound surface dressing in treatment of destroyed damages of the limbs

背景:目前常用的泡沫或海绵生物合成封闭负压引流创面敷料材料临床堵管率高,对于高能损伤所致四肢毁损伤后期创面渗出多、坏死组织多的情况,需反复更换该设备。目的:观察基于生物材料创面敷料的封闭负压引流在四肢毁损伤治疗中的临床效果。方法:选择四肢毁损伤患者36例,在损伤控制性外科手术后,根据患者自愿选择生物材料创面敷料封闭负压引流治疗、合成敷料封闭负压引流治疗、常规传统换药治疗。结果与结论:与常规传统换药组比较,生物材料创面敷料组、合成敷料组采用封闭负压引流能明显缩短住院日,提高二期封闭创面前肉芽组织新鲜度,且生物材料创面敷料组较合成敷料组临床效果更优(P<0.05)。说明新型生物材料创面敷料能有效引流,避免反复多次清创换药对患者身心的损伤,为二期封闭创面提供良好的软组织床。

BACKGROUND： The clinical tube jam rate of wound dressing materials for vacuum-sealing drainage which were foam or sponge biosynthesis material is high. These materials need repeated equipment replacement because of more exudation and necrotic tissues of the high-energy injury destroyed wound in the limbs at the later period. OBJECTIVE： To study the curative effect of vacuum-sealing drainage based on biomaterial wound surface dressings on destroyed damage of the limbs. METHODS： Thirty-six patients with destroyed damage of limbs who underwent damage control surgeries were divided into three groups according to their different wishes： biomaterial wound surface dressing group, synthetic material group, and routine pressure dressing group. RESULTS AND CONCLUSION： The vacuum-sealing drainage used in the biomaterial wound surface dressing group and synthetic material group could obviously shorten the hospitalization time and improve the freshness of granulation tissues before phase II closed wound surgery compared with the routine pressure dressing group. And the vacuum-sealing drainage based on biomaterial wound dressing got a better therapeutic effect （P 〈 0.05）. The vacuum-sealing drainage based on biomaterial wound surface dressing used in destroyed damage of limbs can achieve the effective drainage, avoid repeated debridement damages to patients, and provide good soft tissue bed to phase II closed wound surgery.