基于生物材料创面敷料封闭负压引流在四肢脱套伤治疗中的应用

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

背景:目前常用的以泡沫或海绵合成材料为基础的封闭负压引流临床堵管率高、需反复更换该设备,不能有效引流,影响四肢脱套伤治疗效果。目的:观察基于生物材料创面敷料封闭负压引流在四肢脱套伤治疗中的临床效果。方法:选择四肢脱套伤患者30例,在行原位回植结合吻合动静脉或反取皮植皮等修复性外科手术后,采用自愿方式分生物材料创面敷料、合成敷料、常规传统换药3组治疗。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改善创面循环,降低回植皮肤坏死率,减轻术后患者局部功能障碍程度(P<0.05),且生物材料创面敷料组较合成敷料组临床疗效更优(P<0.05)。说明新型生物材料创面敷料能有效引流,减轻创面静脉负荷,改善四肢脱套伤术后症状。

BACKGROUND：At present,a common vacuum-sealing drainage（VSD） based on foam or sponge synthetic materials has high incidence of the tube plugging and needs to be replaced repeatedly,thereby influencing drainage as well as the effectiveness of degloving injury of the limbs.OBJECTIVE：To investigate the clinical effect of VSD based on biomaterial wound surface dressing on the treatment of degloving injury of the limbs.METHODS：Thirty patients with degloving injury of the limbs were collected.After the patients underwent re-implantation in-situ combined with anastomosis of arteries to veins or anti-taken skin graft,they were treated with biomaterial wound surface dressing,synthetic materials dressing and common dressing changes according their own idea.RESULTS AND CONCLUSION：Compared with common dressing changes group,the VSD used in biomaterial wound surface dressing and synthetic materials dressing groups could significantly improve wound cycle,reduce the necrosis rate of replanted skin and relieve patients’ local dysfunction postoperatively（P 〈 0.05）.In addition,the clinical effectiveness of biomaterial wound surface dressing group was superior to that of synthetic materials dressing group（P 〈 0.05）.These results suggest that the new-type biomaterial wound surface dressing can effectively extract the purulent fluid,reduce wound vein load and improve postoperative symptoms of degloving injury of the limbs.