负压吸引技术在脑膜瘤术后骨瓣下感染中应用

The vacuum sealing drainage applied in the subosseous flap infection after meningioma surgery

目的探讨负压吸引技术在脑膜瘤术后切口感染中的应用。方法选取自2015年1月至2017年12月北部战区总医院烧伤与创面修复外科收治的脑膜瘤术后切口及骨瓣下感染不愈的患者33例为研究对象。所有患者清创后应用负压封闭引流术(VSD)结合创面冲洗治疗,待创面清洁后再行皮瓣复位封闭创面,观察患者恢复情况。结果创面清洁时间为7 d,再次手术后痊愈32例,复发1例,考虑为该例患者乳突部位骨质疏松,存在较多小残腔术中存留细菌,VSD冲洗再次手术时,存留死腔,导致感染复发。结论 VSD配合冲洗治疗脑膜瘤术后感染,方法简单易行,对保守治疗无效的患者,可有效地控制感染、愈合伤口,避免创面长期迁延不愈导致颅内感染。

Objective To investigate the application of vacuum sealing drainage in postoperative incision infection of meningioma.Methods A retrospective study was performed on 33 cases of patients whose incision and bone flap infection was not healed after meningioma surgery admitted from January 2015 to December 2017. After debridement,all patients were treated with vacuum sealing drainage( VSD) combined with wound irrigation. After the wound was cleaned,the flap was repositioned and closed to observe the patients’ recovery. Results The wound surface was cleaned for 7 days,32 patients recovered after the second operation,and 1 patient relapsed. This patient was considered to have osteoporosis in the mastoid part of the patient,and there were many bacteria in the small residual cavity. When the second operation was rinsed with VSD,the dead cavity was retained,leading to the recurrence of infection.Conclusion VSD combined with irrigation in the treatment of postoperative infection of meningioma is a simple and easy method. For patients who fail to respond to conservative treatment,it can effectively control infection and heal wounds,and avoid intracranial infection caused by long-term wound delay.