封闭负压引流联合胸大肌肌皮瓣治疗胸骨切口感染裂开创面的研究

Vacuum-assisted closure therapy combined with pectoralis major muscle flap repair for wound dehiscence following infection of sternal incision

目的:介绍封闭负压引流联合胸大肌肌皮瓣在胸骨切口感染裂开创面手术修复中的应用体会。方法:回顾性分析2010年9月至2014年6月广州医科大学第一附属医院采用封闭负压引流联合胸大肌肌皮瓣修复14例胸骨切口感染裂开创面患者的临床资料,均采用清创后封闭式负压引流,待创面肉芽组织新鲜、感染控制后,用带蒂胸大肌肌皮瓣填塞残腔,修复创面。结果:伤口Ⅰ期愈合12例,2例经换药处理后愈合。平均随访12个月,愈合良好,未发生感染复发及其他并发症。结论:封闭负压引流联合胸大肌肌皮瓣治疗修复胸骨切口感染裂开创面可促进愈合,效果良好。

Objective： To summarize our experiences with vacuum-assisted closure therapy（ VAC）combined with pectoralis major muscle flap repair for wound dehiscence following infection of sternal incision.Methods： This was a retrospective analysis on clinical data from 14 cases of wound dehiscence following sternal incision infection repaired by VAC combined with pectoralis major muscle flap at the First Affiliated Hospital of Guangzhou Medical University between September 2010 and June 2014. Patients were treated with debridement and VAC. After the wound surface was covered with fresh granulation tissues and controlled for infection,pedicled pectoralis major muscle flap was used to fill the residual spaces for wound repair. Results： Primary healing of the wounds was found in 12 cases. Two patients had secondary healing after dressing of the wounds.During the follow-up for a mean of 12 months,the wounds healed well with no recurrence of infection and other complications. Conclusion： VAC combined with pectoralis major muscle flap repair of wound dehiscence after sternal incision infection may promote wound healing with satisfactory efficacy.