负压封闭引流技术在头颈部恶性肿瘤根治重建后下颌下瘘口中的应用评价

Application of vacuum sealing drainage in submandibular fistula after reconstruction with free or pedicled flap following maxillofacial malignant tumors ablation

目的:探讨负压封闭引流技术(vacuum sealing drainage,VSD)在头颈部恶性肿瘤根治重建后下颌下瘘口中应用的可靠性。方法:12例口腔颌面部皮瓣移植修复术后下颌下瘘患者,随机分为试验组和对照组。试验组给予VSD治疗,对照组给予常规换药联合金因肽治疗。结果:试验组治疗1周后拆除负压装置,瘘口收敛,其内充满良性肉芽组织,无渗出。随访4~14个月,瘘口区封闭,愈合良好。对照组经15 d^3个月换药后瘘口封闭。换药期间瘘口不良肉芽组织生长明显,需频繁局部清创。封闭后随访3~21个月,瘘口区愈合。结论:负压封闭引流技术治疗未与口内相通的下颌下瘘口可靠、有效,可缩短住院时间,减轻患者痛苦,减少临床医师的工作量。

PURPOSE： To assess the reliability and usefulness of vacuum sealing drainage（VSD） in submandibular fistula after reconstruction with free or pedicled flap following maxillofacial malignant tumor ablation. METHODS： Twelve submandibular fistulas were randomly divided into the experimental group and control group. The experimental group were given VSD treatment, while the control group was given conventional treatment combined with rh EGF treatment.RESULTS： The VSD were removed after one week of treatment in the experimental group, the fistula was convergent and full of benign granulation tissue. The patients were followed up for 4-14 months, the fistula was closed and the wound healed well. The fistula in the control group was closed after 15 days to 3 months of treatment and the wound healed after3-21 months. CONCLUSIONS： VSD is an effective method for treatment of submandibular fistula after reconstruction with free or pedicled flap following maxillofacial malignant tumor ablation.