钛镍记忆合金线联合负压闭式引流治疗四肢皮肤软组织感染坏死的疗效观察

Efficacy of titanium-nickel memory alloy suture plus with vacuum sealing drainage in treatment of skin and soft tissue infection and necrosis of limb extremities

目的:探讨钛镍记忆合金线联合负压闭式引流(VSD)对四肢皮肤软组织感染坏死术后创面修复的疗效。方法:选取2018年9月至2020年6月广州医科大学附属第五医院收治的40例皮肤软组织感染坏死患者作为研究对象,按随机数字表方法分为治疗组和对照组,每组各20例。治疗组采用钛镍记忆合金线缝合联合VSD引流治疗,对照组采用清创、引流、换药处理。记录并比较两组患者伤口完全闭合所需时间、住院天数、再发感染坏死情况、是否需要进一步干预。结果:两组患者伤口愈合良好。治疗组伤口闭合时间及住院天数均短于对照组(P<0.05);两组均未见伤口再发感染、皮肤坏死。治疗组伤口线性愈合良好,对照组呈疤痕愈合,部分需二期植皮处理。结论:钛镍记忆合金线缝合联合VSD技术在治疗四肢皮肤软组织感染坏死伤口中效果良好。对比传统清洁换药,该技术具有加速伤口愈合,减少住院时间,同时避免伤口二次干预处理等优势,值得在术后的创面修复中推广应用。

Objective:To investigate the efficacy of titanium-nickel memory alloy suture plus vacuum sealing drainage(VSD)in wound repair following skin and soft tissue infection and necrosis of limb extremities.Methods:Forty patients with skin and soft tissue infection and necrosis admitted to Fifth Hospital of Guangzhou Medical University between September 2018 and June 2020 were enrolled,and divided into the treatment group and control group according to random number table(n=20 each).The treatment group was treated with titanium-nickel memory alloy suture plus VSD,while the control group was treated with debridement,usual drainage,and wound dressing.The time to complete wound closure,length of hospital stay,recurrence of infection and necrosis,and need for further intervention were recorded and compared between the two groups.Results:The wounds healed well in the two groups.The time to complete wound closure and length of hospital stay were shorter in the treatment group than those in the control group(P<0.05).There was no recurrence of wound infection and skin necrosis in either group.The treatment group experienced linear healing of the wounds;whereas in the control group,the wounds were mostly healed with scar formation,with secondary skin grafting needed in some patients.Conclusion:Titanium-nickel memory alloy suture plus VSD is effective in handling wounds from skin and soft tissue infection and necrosis of limb extremities.Compared with usual wound cleansing and dressing,the new techniques is advantageous in earlier wound healing,shorter hospital stay,and avoidance of secondary wound intervention,which justifies its widespread use in postoperative wound repair.