负压封闭技术治疗下肢慢性大面积溃疡24例机制研究

Mechanism and curative effect of vacuum sealing technique in treatment of wide chronic ulcer in the lower limbs in 24 cases

目的:下肢慢性溃疡采用传统换药方法效果不佳,负压封闭技术(vacuumsealing,VS)治疗下肢慢性大面积溃疡的机制及疗效有待探讨。方法:24例患者接受VS治疗,清创后将Vacuseal材料覆盖在相应大小的创面上,接50～60kPa的负压,5～7d后植皮或皮瓣转移。结果:24例患者完全治愈,无一例因使用VS死亡,无全身和局部并发症发生;与传统换药方法比较,在植皮或皮瓣转移的时间、换药次数、总体治疗费用等方面差异均有显著性意义(P<0.01)。通过采用局部转移皮瓣关闭5个,植皮关闭19个。结论:VS能防止创面污染,充分引流和剌激创面肉芽组织快速和良好生长。

AIM:Chronic ulcer in the lower limbs is intractable and traditional dressing is apt to cause patients pain. In this study, we aim to investigate the manageme nt of wide chronic ulcer in the lower limbs by vacuum sealing (VS) technique. ME THODS:A total of 24 patients with wide chronic ulcer in the lower limbs were tr eated by VS technique. Following debridement, Polyvinyl alcohol foams containing embedded drainage tubes was used to cover the corresponding wound surface and c onnected with vacuum bottle(negative pressure of 50-60 kPa), and skin grafts or local-regional flap grafts performed after 5-7 days.RESULTS:All patients wer e recovered without death related to VS technique. No systemic or located compli cations were found. Compared with 24 patients managed by traditional dressing (c ontrol group). The average time of VS technique treatment was 7 days. There was a significant difference between 2 groups in time of skin grafts or local-regio nal flap grafts, times of dressing and total expense of patients (P< 0.01). Woun d closure was performed in 5 cases with a local-regional flap and 19 with skin grafting.CONCLUSION:VS technique can protect against wound contamination,comple tely evacuate the wound fluids and stimulate the rapid growth of the granulation tissues.