VSD、皮耐克、自体皮移植序贯法修复皮肤软组织缺损的围手术期处理

The Perioperative Managements of Sequential Treatments,VSD,Pelnac and Autologous Skin Grafting,for the Skin and Soft Tissue Defects

目的分析总结采用序贯法修复皮肤软组织缺损创面的相关经验,以进一步提高该类损伤的处理水平。方法回顾性总结16例皮肤软组织缺损患者序贯应用一期负压封闭引流技术(vacuum sealing drainage,VSD),二期使用皮耐克覆盖,三期使用自体皮移植修复创面的效果及围手术期处理要点。结果 16例皮肤缺损患者中15例创面完全愈合且不留疤痕,1例皮耐克部分溶解经再次植皮后创面愈合。结论采用序贯法修复皮肤缺损创面疗效可靠;严密观察生命体征、注意伤口封闭情况、引流量及敷料渗湿情况、做好相关护理、加强营养及正确选择序贯法手术时机有利于促进患者早日康复。

Abstract： Objective To summarize the perioperative experiences of the sequential treatments— vacuum sealing drainage （VSD）, artificial dermis （Pelnac） and autologous skin grafting for the skin and soft tissue defects eansed by trauma, so as to further improve the treatment of these injuries. Methods The re- sults and perioperative managements were retrospectively reviewed from 16 cases with skin and soft tissue de- fects treated by the sequential treatments： first stage with VSD coverage, then with Pelnac coverage, and at last with autologous skin grafting to repair the wounds. Results The wounds of 15 patients with skin and soft tis- sue defects were completely healed without leaving scars, except 1 patient＇s wound was healed after a second Pelnac graft because of the partial solution of the first Pelnac. Conclusions It is reliable of the sequential treatments to repair the skin and soft tissue defects. And it is conducive to promote the recovery of the patients with the key points of carefully monitoring the alterations of vital signs, attention to the wound closure, the drainage, and the dressing wetness, better nutrition and the opportunity choices for the operation time of the se- quential treatments.