一期拉网植皮联合VSD(负压封闭引流技术)治疗皮肤撕脱伤及缺损

The first phase seine skin graft combined with VSD in the treatment of skin avulsion injury and defect

目的研究一期拉网植皮联合VSD（负压封闭引流技术Vacuum Sealing Drainage）治疗开放性皮肤撕脱及缺损的疗效。方法 2011年2月至2015年2月期间,对16例皮肤软组织撕脱伤及缺损的患者,采用彻底清创后一期拉网植皮联合VSD覆盖创面,连接负压封闭吸引,10~12天拆除VSD材料后经过短时间换药达到伤口愈合。结果 16例中,2例植皮存活率80%,但皮肤坏死面积较小,经过定期换药后愈合。其余14例植皮区均存活90%以上,短期创面换药后即愈合出院。患者对治疗效果满意。结论一期清创拉网植皮联合VSD覆盖创面治疗皮肤撕脱伤及缺损有效,可以在充分引流的情况下预防感染,同时创面内的适宜负压可增加植皮的存活率。该方法可以避免患者进行第二次手术,大大缩短病人的住院时间,并降低了经济负担,可以取得满意的疗效。

Objective To study the curative effect of first phase seine skin graft combined with VSD in the treatment of skin avulsion injury and defect .Methods From February 2012 to February 2015, 16 cases of skin avulsion injury and defect were cured by a new therapeutic method： in the first phase operation , after completed debridement , we grafted the seine autologous -skin on the surface of the wound , and then covered with VSD （Vacuum Sealing Drainage ）.10-12days after operation, we removed VSD.The wound then healed with changing dressings after short time .Results After the treatment, 80% grafted skin survived in 2 cases.To the rest 14 cases,more than 90%grafted skin survived.All the cases healed in short time after removing VSD .Most patients felt satisfied .Conclusions The therapeutic method is effective for skin avulsion injury and defect .It can prevent infection by adequate drainage ,and also increase the survival rate of skin grafting .Most patients will avoid second-operation.It can shorten hospital stays and reduce hospitalization cost .So the results will be satisfied .