封闭负压引流技术在感染性骨折伴皮肤缺损治疗中的应用

Application of continuous vacuum assisted closure in treatment of infective nonunion accompanied by soft tissue defect

目的探讨封闭负压引流技术(VSD)在感染性骨折伴皮肤缺损治疗中的应用价值,为临床治疗提供参考。方法选取医院2009年3月-2012年2月感染性骨折伴皮肤缺损病例62例,随机分为对照组和治疗组各31例,对照组采用传统治疗方法,彻底清理创面,去除坏死及血运不良组织,外用敷料包扎,创面较大时可放置引流条,根据渗出情况每24～48h换药1次,直至创面达到缝合或植皮标准;治疗组则在传统治疗方法上加用持续封闭负压引流技术,保证创腔的持续充分引流;将两组患者的创面愈合率及创面愈合时间进行对照分析。结果治疗组一次植皮后创面愈合率为100.00%,明显高于对照组的58.06%,差异有统计学意义(P<0.05);平均愈合时间14.34d,明显低于对照组的21.53d,差异有统计学意义(P<0.05)。结论持续封闭负压引流技术具有创面愈合时间短、感染率低等优点;在感染性骨折伴皮肤缺损治疗中具有较高的应用价值。

OBJECTIVE To investigate the application of the continuous vacuum assisted closure in treatment of infective nonunion accompanied with soft tissue defect so as to provide reference for the clinical therapy. METHODS A total of 62 patients with infective nonunion accompanied with soft tissue defect were selected from Mar 2009 to Feb 2012 and were randomly divided into the control group and the treatment group with 31 cases in each, the control group was treated with traditional clinical treatment, the wounds were thoroughly cleaned up, the necrosis or unhealthy tissues was removed, the wound surface was wrapped up with dressings, the drainage strip was placed as the wound was big, according to the effusion, the dressings were changed once for each 24-48 hours till the wound meet the standard of suture or dermatoplasty, while the treatment group was treated with continuous vacuum assisted closure therapy on the basis of the traditional therapy so as to ensure the continuous and adequate drainage of the wound cavity. RESULTS The wound healing rate in treatment group （100.00 %） was significantly higher than that of control group （58.06%）, the difference was statistically significant （P〈0.05）. The average healing time of the treatment group （14.34 days） was significantly shorter than that of the control group （21.53 days）, the difference was significantly significant （P〈0.05）. CONCLUSION The vacuum assisted closure technique is with the short wound healing time and the low infection rate, thus it has significant application value in the treatment of infective nonunion accompanied by soft tissue defect.