负压封闭引流技术在腹部带蒂皮瓣供瓣区的应用

Clinical Application of the Vaccum Sealing Drainage in Donor Site of Pedicled Abdominal Flap

目的:探讨负压封闭引流(vaccumsealingdrainage,VSD)技术在腹部带蒂皮瓣供瓣区中的治疗作用。方法:10例上肢深度创面大小为9×6 cm-14×9 cm,创面清创后行腹部带蒂皮瓣移植,皮瓣面积10×7 cm-20×15 cm,供瓣区应用VSD覆盖,医用半透性贴膜封闭整个术区,连接中心负压,持续低负压吸引,每日外用1000 mL生理盐水持续冲洗VSD。约3周后行皮瓣断蒂术,供瓣区植皮。结果:10例皮瓣全部存活,1例患者术后当天引流区域出现疼痛,经止痛治疗后未再出现。1例患者术后2周出现VSD堵塞,经处理后恢复正常引流。无VSD装置更换病例。供瓣区周边皮肤无浸渍及感染现象,VSD撤除后见基底肉芽组织生长新鲜,创面均无感染,移植皮片存活。结论:VSD技术可以有效保护供瓣区,刺激肉芽生长,为后期皮片移植闭合创面提供了良好条件。VSD技术可安全有效的应用于腹部带蒂皮瓣供瓣区。

Objective： To explore the clinical effects of vaccum sealing drainage （VSD） applications in donor site of abdominal flap. Methods： 10 patients with upper extremity deep wounds repaired by abdominal flap from February 2012 to January 2013 were enrolled in the study. The wounds measured from 9 cm× 6 cm to 14 cm× 9 cm were covered with pedicled abdominal flap. The area of flaps ranged from 10 cm× 7 cm to 20 cm× 15 cm. The donor site of the pedicled abdominal flap were covered by medical sponge and the medical semi-permeable paste film closed the entire surgery area. Then connected suction device and given daily 1000 ml saline to medical sponge. The pedicle division surgery underwent 3 weeks after flap transplantation. The donor site of flap was covered with skin grafting. Results： In all cases the flaps survived, one patient complained of drainage area pain at first postoperative day and the pain did not recur after treatment. VSD was clogged at two weeks postoperative day in one patient and visible leakage phenomenon did not occur after treatment. There was no VSD device replacement cases. There was no dipping or infection phenomenon surrounding the donor site of flap. The fresh granulation tissue grow after removing VSD and skin graft survive. Conclusion： VSD technology can effectively protect the donor site, stimulate growth of granulation and provide good condition for latter wound closure. VSD technology can be used safely and effectively for abdominal pedicle flap donor area.