负压引流联合带蒂复合组织瓣移植修复创伤后软组织缺损的临床研究

Clinical research of vacuum sealing drainage combined pedicle composite tissue flap for the reparation of post-traumatic soft tissue defects

目的：探讨封闭负压引流联合带蒂复合组织瓣移植修复创伤后软组织缺损的临床疗效。方法选取江门市人民医院2008年1月-2012年1月收治的62例创伤后软组织缺损患者，分为观察组和对照组，每组各31例。观察组患者接受VSD联合带蒂复合组织瓣移植修复，对照组患者待创面坏死组织溶解、肉芽组织生长、再行皮瓣修复术，比较两组治疗效果。结果观察组患者术后肢体功能恢复优良率（90.3%）明显优于对照组（64.5%），差异有统计学意义（P〈0.05）。观察组患者术后满意度（93.5%）明显高于对照组（74.1%），差异有统计学意义（P〈0.05）；观察组患者术前住院时间[（11.4±7.6）d]、术后住院时间[（34.8±27.6）d]及住院费用[（7854.52±1563.71）元]明显低于对照组[（25.3±11.4）d、（59.5±31.2）d、（12145.61±2103.4）元]，差异有统计学意义（P〈0.05）。结论负压引流联合带蒂复合组织瓣移植修复具有防止创面污染、缩短治疗时间、促进患者肢体功能恢复、提高患者满意度等优点，是一种较为简单有效的创伤后软组织缺损治疗方法。

Objective To evaluate the clinical efficacy of the vacuum sealing drainage （VSD） combined pedicle com-posite tissue flap for the reparation of post-traumatic soft tissue defects. Methods From January 2008 to January 2012, in the People＆#39;s Hospital of Jiangmen City, 62 patients with trauma soft tissue defects were selected and divided into observation group and control group, with 31 cases in each group, the patients of observation group were received VSD combined pedicle composite tissue flap to repair, the control group were received flap surgery after the dissolution of necrotic tissue and granulation tissue growth, the efficacy of two groups were compared. Results The rate of excellent and good functional recovery of upper limb in observation group （90.3%） was significantly better than that in the control group （65.5%）, the difference was statistically significant （P〈 0.05）. The postoperative satisfaction of patients in obser-vation group （93.5%） was significantly higher than that of the control group （74.1%）, the difference was statistically sig-nificant （P〈 0.05）. The hospitalization time before operation [（11.4±7.6） d], hospitalization time after operation [（34.8±27.6） d], and hospitalization costs [（7854.52±1563.71） yuan] in the observation group were lower than those in the con-trol group [（25.3±11.4） d, （59.5±31.2） d, （12 145.61±2103.4） yuan], the differences were statistically significant （P 〈0.05）. Conclusion VSD combined pedicle composite tissue flap can prevent wound contamination, shorten treatment time, promote patient recovery of limb function, improve patients＆#39; satisfaction and so on, it is a simple and effective method of treatment for post-traumatic soft tissue defects.