水刀精准清创结合负压渐退法治疗坏死性筋膜炎的疗效观察

Observation on the curative effect of precise debridement with hydrodynamic debridement system combined with negative pressure gradual retreat in the treatment of necrotizing fasciitis

目的探索水刀精准清创结合负压渐退法治疗坏死性筋膜炎(Necrotizing fasciitis,NF)的临床疗效。方法选取2017年1月至2020年12月收治的15例NF患者。合并症:糖尿病患者9例,高血压患者2例,肿瘤患者2例,慢性肝病患者1例,虫咬伤1例。感染部位:臀部、肛周8例,下肢6例,颈部1例。采用水刀精准清创结合负压渐退法彻底清创,并逐步封闭创面。结果15例患者均存活,创面均于6~8周完全封闭,其中4例直接缝合,11例行皮片移植,最终全部成活。所有患者随访1年均未见复发。结论水刀精准清创结合负压渐退法是治疗NF行之有效的方法。

Objective To explore the clinical efficacy of precise debridement with hydrodynamic debridement system combined with negative pressure gradual retreat in the treatment of necrotizing fasciitis(NF).Methods A total of 15 patients suffered with NF were selected from January 2017 to December 2020.Complications:9 cases with diabetes,2 cases with hypertension,2 cases with tumor,1 case with chronic liver disease,1 case with insect bite.Infected sites:buttocks and perianal in 8 cases,lower limbs in 6 cases,neck in 1 case.The method of precise hydrodynamic debridement combined with negative pressure gradual retreat was used to debride completely and seal repair the wound gradually.Results All the 15 patients survived.Wounds were completely repaired in 6-8 weeks.4 cases were sutured directly and 11 cases underwent skin grafting and all survived.All patients were followed up for 1 year,and no recurrence was observed.Conclusion Precise debridement with hydrodynamic debridement system combined with negative pressure gradual retreat is an effective method for the treatment of NF.