封闭负压引流技术在手足部软组织撕脱伤缺损治疗中的应用

Application of vacuum sealing drainage technique in the treatment of soft tissue avulsion defect of hand and foot

目的探讨封闭负压引流(VSD)技术在手足部软组织撕脱伤缺损治疗中的作用。方法采用VSD技术结合二期手术治疗46例手足部软组织撕脱伤缺损患者。软组织缺损面积3 cm×4 cm^7 cm×20 cm。结果患者均获得随访,时间3~81个月。患者创面全部治愈,无全身及局部毒性反应。VSD治疗时间为5~22 d。二期处理:22例创面直接缝合,20例行游离皮片移植,4例行游离皮瓣移植修复。二期创面愈合时间17~34 d。皮瓣均一期成活,1例外观稍臃肿,其余皮瓣外形好;感觉及耐磨功能基本恢复正常,手足部外形恢复满意。结论应用VSD技术治疗,肉芽组织生长快速、稳定,有利于创面早期修复,是治疗手足部软组织撕脱伤缺损简便有效的方法。

Objective To explore the effect of vacuum sealing drainage( VSD) technique in the treatment of the soft tissue avulsion defect of the hand and food.Methods The 46 patients with soft tissue avulsion defect of hand and foot were treated by VSD technique and the second operation was combined to repair the wound surface.The defect area of soft tissue was 3 cm × 4 cm ~ 7 cm × 20 cm.Results All the patients were followed up for 3 ~ 81 months.All patients were cured without systemic or local toxicity.The treatment time of VSD was 5 ~ 22 d.Secondary treatment: 22 patients were directly sutured,20 were treated with free skin graft,4 were grafted by free-flap,and the second stage wound healing time was 17 ~ 34 d.All the wounds were cured,and all the skin flaps survived in the first stage,one patient had a slightly swollen appearance,while the rest of the skin slaps had a good appearance,the shape of hand and foot recovered satisfactorily.Conclusions The application of VSD technique in the treatment of granulation tissue growth is rapid and stable,which is beneficial to repair early and is a simple and effective method to treat the soft tissue avulsion defect of the hand and food.