负压封闭引流技术在腕部开放性复杂创面的应用

THE FUNCTION OF VACUUM SEALING DRAINAGE IN THE TREATMENT OF OPEN COMPLEX WRIST INJURY

目的探讨负压封闭引流（vacuum sealing drainage）技术在腕部开放性复杂损伤中临时覆盖创面的疗效。方法回顾性分析2007年6月—2014年12月收治的开放性复杂腕部损伤25例,男18例,女7例,年龄15~50岁,平均28.4岁,一期清创VSD临时覆盖创面,控制感染,局部组织条件允许,肉芽组织生长良好后,选用游离植皮或皮瓣最终闭合创面。术后观察创面、骨折愈合情况,腕部功能及并发症情况。结果 15例更换VSD1次,5例更换2次,3例更换3次,2例更换4次。14例行游离植皮术,11例行皮瓣修复术。1例植皮出现部分坏死,坏死面积约20%,其余创面愈合良好,未发生感染,肌腱肌肉、骨组织无外露。结论一期清创、VSD临时覆盖,二期行游离植皮、皮瓣修复,可简单、安全、有效的治疗腕部开放性复杂创面。

Objective To investigate the effect of vacuum sealing drainage（VSD）in the treatment of open complex wrist injury.Methods We retrospectively reviewed the 25 patients who with the open complex wrist injury from June 2007 to December 2014.There were 18 males and 7 females,aged from15 to 50years（average age 28.4 years）.All 25 cases were treated by VSD technique in combination with primary debridement.When local infections were controlled and wound conditions were improved,the wounds were closed by free skin graft or flap.Wound recovery,fracture healing,wrist function and complications were followed up.Results After 15 cases treated with 1 times of VSD,5 cases with 2 times of VSD,3 cases with 3 times of VSD,2 cases with4 times of VSD,the wounds were covered by free skin graft in14 cases,flap in11 cases.1 case of free skin graft occurred partial necrosis of twenty percent.24 cases wounds healing was well,there was no infection and tendon exposure.Conclusion VSD technique in combination with primary debridement followed by free skin graft or flaps is safe,easy and effective in the treatment of open complex wrist injury.