VSD在创伤后肢体软组织缺损中的应用

Application of VSD technique inextremity traumaticskin and soft tissue injury

目的：探讨负压封闭引流（vacuum sealing drainage,VSD）技术应用于创伤后肢体皮肤软组织损伤的治疗效果。方法：2012年7月至2014年8月,80例创伤后肢体皮肤软组织损伤患者均彻底清创后,结合VSD治疗待创面肉芽生长良好后行自体断层刃厚皮片移植,其中合并肢体骨折患者均Ⅰ期对骨折进行复位,并且必要时在开放伤口的旁边安装外固定支架。结果：80例创伤后肢体皮肤软组织损伤患者均于术后21~47 d愈合,创面平均愈合时间为（25.2±2.6）d。合并骨折患者手术切口均达到I期愈合,无深部组织感染及骨髓炎发生。所有患者经过1~3次间歇性VSD治疗后创面达到植皮条件,然后进行自体断层刃厚皮片移植联合持续性VSD治疗后愈合。结论：VSD治疗不同程度创伤后肢体皮肤软组织损伤,有效促进创面肉芽组织及皮片生长,临床疗效满意。

Objective： To investigate the effect of the closed vacuum sealing drainage（VSD） technology in the treatment of post-traumatic limb skin soft tissue injuries. Methods： Eighty patients with post-traumatic limb skin soft tissue injuries admitted to our department from July 2012 ~ August 2014 were selected for the study. The wounds were thorough debrided and the VSD was added to the treatment until wound granulation grew well. Then an autologous split-thickness skin flap was engrafted and those who came with fracture were performed fracture reduction on admission and an external fixator was placed in case of an open wound. Results： The wounds of all patients were closed from post-operation day 21 to 47, averaging 25.2 ± 2.6 days. The surgical wounds on those who came with fracture were closed primarily, without deep tissue infection and osteomyelitis. The wounds in all patients met the requirements for skin graft after 1 to 3 times of intermittent VSD, and were then resolved after autologous tomography split thickness skin graft combined with VSD therapy. Conclusion： VSD is effective in the treatment of skin and soft tissue injury of the extremities after trauma, and can effectively promote the growth of granulation tissue and skin of the wound.