负压封闭引流技术在下肢大面积皮肤撕脱伤治疗中的应用

Application of vacuum sealing drainage in the treatment of large skin avulsion of lower extremities

目的 探讨负压封闭引流技术在下肢大面积皮肤撕脱伤治疗中的疗效.方法 采用反取皮全厚、中厚皮片和真皮下血管网皮瓣原位植皮联合负压封闭引流技术治疗下肢大面积皮肤撕脱伤患者24例.结果 16例患者创面一期封闭,6例发生小范围皮片坏死,经换药后愈合,2例皮片坏死较大者经过二次邮票植皮完全愈合.所有患者均获随访,随访时间6～36个月,平均24个月.保留真皮下血管网皮瓣原位植皮者肢体外观色泽接近正常,弹性及感觉功能较好,关节功能良好;全厚及中厚皮片原位植皮者有少量瘢痕增生,功能恢复满意.本组未发生骨、关节及软组织感染等并发症.结论 下肢大面积皮肤撕脱伤植皮后应用负压封闭引流技术,可有效控制感染,促进皮片与创面贴附,有利于皮片存活,值得临床推广应用.

Objective To investigate the efficacy of vacuum sealing drainage in the treatment of large skin avulsion of lower extremities.Methods The anti-take the skin thickness in the skin graft and subdermal vascular network flap in situ graft joint vacuum sealing drainage were performed in the treatment of 24 patients with skin of lower limbs avulsion.Results Sixteen patients suffered a closed wound; 6 suffered small skin graft necrosis and were cured after changing dressing; 2 suffered skin flap necrosis and were healed completely after the second stamp skin graft.All patients were followed up for 6 to 36 months,with an average of 24 months.The subdermal vascular network flap in situ graft limb had appearance and color close to normal,with good flexibility and joint function; situ skin grafting of full-thickness skin graft had a small amount of scar,and functional recovery was satisfactory.No bones,joints and soft tissue infections and other complications occured.Conclusion Vacuum sealing drainage can effectively control the infection,and promote skin grafts and wound attached in the treatment of the skin of lower limbs avulsion,which is good for the survival of skin grafts.