负压封闭引流术在四肢创伤合并大面积皮肤软组织缺损中的临床应用

Clinical application of vacuum sealing drainage in trauma of extremity combined with massive soft tissue defects

目的探讨负压封闭引流(VSD)技术在治疗四肢创伤合并大面积皮肤软组织缺损中的临床疗效。方法收集2009年11月至2010年11月咸阳市核工业215医院手外科收治的58例四肢创伤合并皮肤软组织缺损患者的临床资料,其中男性38例,女性20例;年龄12～72岁,平均年龄42.00岁。对其均给予彻底清创,肌腱、血管神经修复,骨折内固定或外固定后行VSD治疗,创面用VSD材料封闭,持续负压引流的方法进行治疗。结果 36例一次性治疗,局部转移皮瓣10例,岛状皮瓣移植12例。所有病例缺损创面肉芽生长良好,行皮片移植或皮瓣修复后创面均愈合,骨折全部愈合,无明显功能障碍。并发症:引流管堵塞6例,膜下积液2例。结论 VSD技术操作简便,安全有效,在治疗四肢创伤并软组织缺损中疗效显著。

Objective To investigate the indication and clinical curative effect of vacuum sealing drainage（VSD） for trauma of the extremity combined with massive soft tissue defects. Methods From November 2009 to November 2010, a total of 58 patients with trauma of the extremities combined with skin and soft tissue defection were enrolled, male 38, female 20, aged 12 - 72 years old, mean age 42.00 years old. They were given a thorough debridement, tendon, blood vessel and nerve repair, fracture internal fixation or external fixation, irrigation tube was placed for irrigation, and then wound area was covered with VSD system. Results The 36 patients were performed one-time treatment,10 cases with local flap transfer and 12 cases with island flap transplantation. In all cases, defect wound granulation~ skin graft or skin flap was healed the wound, all fractures repaired, and no obvious dysfunction occurred. The complication included the drainage tube clogging in 6 cases and membrane effusion in 2 cases. Conclusion It is demonstrated that VSD is a simple, safe and effective technique, it is significant effective in treatment of trauma of extremity combined with soft tissue defects.