负压封闭引流技术辅助组织瓣修复复杂或慢性创面

Vacuum-Assisted Closure with Vascularized Tissue Flaps in Repairing Complex or Chronic Wounds

目的观察负压封闭引流技术应用于术前准备阶段协助组织瓣修复复杂或慢性创面的作用。方法回顾分析近2年来用此方案治疗的8例复杂或慢性创面患者．入院时均存在不同程度的创面血运差、骨或其他深部组织外露和顽固感染，一期先行清创手术后使用VSD持续负压吸引创面治疗，待创面新鲜无感染、肉芽丰富后，二期行组织瓣（包括带蒂组织瓣和游离组织瓣）移植覆盖创面。结果应用VSD技术可有效控制创面感染，促进肉芽组织生长。移植皮瓣全部成活，随访3-16个月，无慢性感染、溃疡和窦道存在，效果满意。结论术前正确应用VSD技术，可使创面准备相对简便和快捷．可有效地协助组织瓣修复复杂或慢性创面．值得临床推广和进一步深入研究。

Objective To investigate the efficacy of vacuum-assisted closure preoperatively with vascularized tissue flaps in repairing complex or chronic wounds. Methods Retrospective analysis of 8 cases with complex or chronic wounds during the last two years was performed. All the eight patients presented with different degrees of wound ischaemia, bone or other deep tissues exposure and persistent local infection. Primary debridement and vacuum sealing drainage （VSD） were administered until the appearance of clean wound without infection and formation of abundant granulation tissue. Vascularized tissue fiap was used after vacuum-assisted closure. Results Persistent application of negative pressure was beneficial for local infection control and granulation tissue growth. All tissue flaps survived with satisfactory outcome and no chronic infection, ulcer and fistula were observed after fofiow-up for 3-16 months. Conclusion Vacuum-assisted closure can make wound preparation more convenient and less time-consumed. It is effective in repairing complex or chronic wound combining with vascularized tissue flaps and should be further investigated.