负压封闭引流技术和传统换药治疗四肢软组织缺损创面效果比较

Clinical effect comparison of using vacuum sealing drainage technology and conventional dressing change to deal with defect of limb's soft tissue

目的:通过对负压封闭引流技术(VSD)与临床传统换药(CDC)两种方法治疗四肢皮肤软组织缺损创面进行临床效果对比,为医院及医疗卫生决策提供理论依据。方法:收集西安交通大学附属第一附属医院烧伤整形美容科2007年1月至2011年7月期间入院的四肢皮肤软组织缺损创面患者共218例,其中使用VSD治疗的患者108例,使用CDC治疗的患者110例。比较两组患者治疗过程中手术前所需的治疗时间、首次植皮存活率、手术次数、并发症、住院时间、创面愈合等级、再次入院率等临床效果指标。结果:VSD与CDC组手术前所需的治疗时间、首次植皮存活率、手术次数、并发症的发生、住院天数、再次入院率的差异均有统计学意义,VSD组临床效果明显优于CDC组。结论:与临床传统换药相比,VSD治疗皮肤软组织缺损创面炎症反应较轻,并发症少且轻,明显缩短首次植皮时间,植皮存活率较高,减少手术次数,且再次入院率低,缩短患者住院时间,降低住院医疗费用,同时减轻了医护人员的劳动强度。

Objective Through comparison of clinical effect between using vacuum sealing drainage （VSD） technology and conventional dressing change （CDC） to deal with defect of limb＇s soft tissue,to provide a theoretical basis for health decision-making. Methods From January 2007 to July 2011,218 patients in total with defects of limb＇s soft tissue were treated and followed up in trauma plastic surgery department of First Affiliated Hospital of Xi＇an Jiaotong University.108 patients were treated by VSD and 110 patients were treated by CDC. Record the time needed before skin-grafting, the survival rate of first time skin-grafting,number of operations,different kinds of complications encountered,the time of treatment,the situation of the wound healing and readmission rates,compare the clinical effectiveness indicators. Results There was a significant difference between VSD group and CDC group in time needed before skin-grafting,survival rate of first time skin-grafting, numbers of operations,complications,total time in hospital and readmission rates. VSD group＇s clinical effect is better than those in CDC group. Conclusion Compared with the traditional clinical change dressings, the VSD treatment of skin and soft tissue defect wound have so much dominance,such as：inflammation is lighter,less complications and light, significantly shorten the time of the first graft,increase the skin graft survival rate, reduce the operation and readmission rate,shorten time in hospital, reduce hospitalization medical expenses, meanwhile, reduced the labor intensity of medical staff.