负压封闭引流联合冲洗与传统处理法对四肢火器伤软组织缺损的初期疗效观察

Comparison Study between VSD Combined with Irrigation and Conventional Management in Treating Firearm Soft Tissue Defects in Extremities

目的比较负压封闭引流(vacuum sealing drainage,VSD)联合冲洗与传统处理法初期治疗在四肢火器伤软组织缺损的临床效果。方法回顾性分析2002-01/2012-01月间应用VSD联合冲洗(28例)及传统处理法(26例)初期治疗四肢火器伤软组织缺损患者54例,比较两种治疗方法在二期创面闭合时间、换药次数及感染发生率等方面的差异。结果 VSD联合冲洗治疗法在二期创面闭合时间、换药次数、感染发生率等方面均优于传统处理法,差异有统计学意义(P<0.05)。结论 VSD联合冲洗应用于四肢火器伤软组织缺损初期治疗可行最小限度的清创,控制感染,缩短治疗时间,为二期创面闭合提供良好的条件。

Objective To compare the early clinical effect between vacuum sealing drainage （VSD） combined with irrigation and traditional treatment on firearm soft tissue defects in extremities. Methods From January 2002 to January 2012, 54 patients with firearm soft tissue defects in extremities were respectively treated with VSD combined with irrigation （n = 28） and traditional treatment （n = 26）. The number of days between initial debridement and wound closure, number of dressing changes, infection rate were compared between two groups. Results The number of days between in- itial debridement and wound closure, number of dressing changes, infection rate which were treated with VSD combined with irrigation were less than the traditional treatment. There was significantly different between two groups（P〈0. 05）. Conclusion VSD combined with irrigation are effective methods for the early treatment of the firearm soft tissue defects in extremities, which can cut down infection rate, decrease treatment time, provide good conditions for the wound repair in the second stage.