Novel Application of Vacuum Sealing Drainage with Continuous Irrigation of Potassium Permanganate for Managing Infective Wounds of Gas Gangrene

Summary： Traumatic gas gangrene is a fatal infection mainly caused by Clostridium perfringens. It is a challenge to manage gas gangrene in open wounds and control infection after debridement or amputa- tion. The aim of the present study was to use vacuum sealing drainage （VSD） with continuous irrigation of potassium permanganate to manage infective wounds of gas gangrene and observe its clinical effi- cacy. A total of 48 patients with open traumatic gas gangrene infection were included in this study. Am- putations were done for 27 patients, and limb salvage procedures were performed for the others. After amputation or aggressive debridement, the VSD system, including polyvinyl alcohol （PVA） foam dress- ing and polyurethane （PU） film, with continuous irrigation of 1：5000 potassium permanganate solutions, was applied to the wounds. During the follow-up, all the patients healed without recurrence within 8-18 months. There were four complications. Cardiac arrest during amputation surgery occurred in one pa- tient who suffered from severe septic shock. Emergent resuscitation was performed and the patient re- turned to stable condition. One patient suffered from mixed infection of Staphylococcal aureus, and a second-stage debridement was performed. One patient suffered from severe pain of the limb after the debridement. Exploratory operation was done and the possible reason was trauma of a local peripheral nerve. Three cases of crush syndrome had dialysis treatment for concomitant renal failure. In conclusion, VSD can convert open wound to closed wound, and evacuate necrotic tissues. Furthermore, potassium permanganate solutions help eliminate anaerobic microenviroument and achieve good therapeutic effect on gas gangrene and mixed infection. VSD with continuous irrigation of potassium permanganate is a novel, simple and feasible alternative for severe traumatic open wounds with gas gangrene infection.

Recombinant human epidermal growth factor combined with vacuum sealing drainage for wound healing in Bama pigs

Background:Vacuum sealing drainage(VSD)and epidermal growth factor(EGF)both play an important role in the treatment of wounds.This study aims to explore the effects of the combination of VSD and EGF on wound healing and the optimal concentration and time of EGF.Methods:We tested the proliferation and migration capacity of HaCaT and L929 cells at different EGF concentrations(0,1,5,10,and 100ng/ml)and different EGF action times(2,10,and 30min).A full-thickness skin defect model was established using male,30-week-old Bama pigs.The experiment included groups as follows:routine dressing change after covering with sterile auxiliary material(Control),continuous negative pressure drainage of the wound(VSD),continuous negative pressure drainage of the wound and injection of EGF 10min followed by removal by continuous lavage(V+E 10min),and continuous negative pressure drainage of the wound and injection of EGF 30min followed by removal by continuous lavage(V+E 30min).The wound healing rate,histological repair effect and collagen deposition were compared among the four groups.Results:An EGF concentration of 10ng/ml and an action time of 10min had optimal effects on the proliferation and migration capacities of HaCaT and L929 cells.The drug dispersion effect was better than drug infusion after bolus injection effect,and the contact surface was wider.Compared with other groups,the V+E 10min group promoted wound healing to the greatest extent and obtained the best histological score.Conclusions:A recombinant human epidermal growth factor(rhEGF)concentration of 10 ng/ml can promote the proliferation and migration of epithelial cells and fibroblasts to the greatest extent in vitro.VSD combined with rhEGF kept in place for 10min and then washed,can promote wound healing better than the other treatments in vitro.

Salvage of vascular graft infections via vacuum sealing drainage and rectus femoris muscle flap transposition: A case report

BACKGROUND The management of vascular graft infections continues to be a significant challenge in a clinical situation.The aim of this report is to illustrate the novel vacuum sealing drainage(VSD)technique and rectus femoris muscle flap transposition for vascular graft infections,and to evaluate the prospective of future testing of this surgical procedure.CASE SUMMARY We report the case of a 32-year-old male patient,who presented a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure.Using the VSD and muscle flap transposition,the groin wound and vascular graft infection were finally treated successfully.CONCLUSION Our case report highlights that VSD technique and rectus femoris muscle flap transposition could be considered in patients presenting with a severe infected groin wound with biological vascular graft Acinetobacter baumannii infection resulting in extensive graft exposure,especially in consideration of treatable conditions.

Effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting

Objective: To study the effect of vacuum sealing drainage combined with biological dressings on the angiogenesis and inflammatory response after diabetic foot ulcer wound grafting. Methods: Patients with diabetic foot who were treated in Sichuan Provincial People's Hospital between May 2014 and February 2017 were selected and randomly divided into vacuum drainage group and normal control group who received vacuum sealing drainage combined with biological dressings as well as conventional debridement and dressing change to deal with the wound respectively. Before treatment as well as 1 d, 3 d and 5 d after treatment, the wound tissue was collected to determine the expression of angiogenesis molecules, angiogenesis signaling pathway molecules and inflammatory response molecules. Results: 1 d, 3 d and 5 d after treatment, VEGF, VEGFR, CD105, MMP9, PI3K, AKT, cyclinD1, p38MAPK and NF-kB protein expression in wound tissue of vacuum drainage group were significantly higher than those of normal control group while COX-2, iNOS, TNF-α and IL-6 mRNA expression were significantly lower than those of normal control group. Conclusion: Vacuum sealing drainage combined with biological dressings promotes the angiogenesis and inhibits the inflammatory response after diabetic foot ulcer wound grafting.

Assessment of the trauma degree and bone metabolism after external fixation combined with vacuum sealing drainage treatment of open tibiofibula fracture

Objective: To evaluate the effect of external fixation combined with vacuum sealing drainage on the trauma degree and bone metabolism in patients with open tibiofibula fracture. Methods:A total of 116 patients with open tibiofibula fracture who received surgical treatment in Luzhou People's Hospital between February 2015 and January 2017 were divided into control group (n=58) and study group (n=58) by random number table. Control group received debridement + external fixation, and study group received debridement + external fixation +vacuum sealing drainage. The differences in the levels of trauma indexes and bone metabolism indexes were compared between the two groups before and after treatment. Results: Before surgery, there was no statistically significant difference in serum levels of trauma indexes and bone metabolism indexes between the two groups. 1 week after surgery, serum acute phase protein Tf level of study group was higher than that of control group whereas CER, Hp and CRP levels were lower than those of control group;stress indexes NE and Cor levels were lower than those of control group;bone metabolism indexes P1NP, BGP and BALP levels were higher than those of control group whereas β-CTX level was lower than that of control group. Conclusion: External fixation combined with vacuum sealing drainage can effectively reduce fracture trauma and promote fracture end healing in patients with open tibiofibula fracture.

Application of vacuum sealing drainage in skin graft of calf pedicle island flap donor-site

Objective: To explore the clinical effect of vacuum sealing drainage on free dermatoplasty in the donor-site of calf pedicled island flap. Method: From January 2016 to January 2018, a total of 70 patients undergoing reconstruction of skin and soft tissue defects in ankles and legs with calf pedicle island flap in Foshan Traditional Chinese Medicine Hospital were selected into our research. Selected patients were divided into VSD group and pressure dressing group according to the order of surgery. The VSD group was treated with free skin grafting and vacuum sealing drainage after separation of donor-site flap. The pressure dressing group was treated with free skin grafting and traditional pressure dressing technology after the separation of donor-site flap. Visual acuity simulation scores (VAS) were observed and recorded on the 1st, 7th, and 14th day after surgery. The unpacking time, skin graft healing time, skin graft survival rate, infection rate and incidence of subcutaneous hematoma were compared between the two groups. Results: The VAS scores on the 7th and 14th day after surgery in the VSD group were lower than those in the pressure dressing group. The unpacking time and skin graft healing time of the VSD group were shorter than those of the pressure dressing group. The survival rate of skin graft in VSD group was higher than that in the pressure dressing group. The infection rate and the incidence of subcutaneous hematoma in the VSD group were lower than those in the pressure dressing group. Conclusion: Vacuum sealing drainage is beneficial to promote the healing of free skin grafts in the donor site of the calf pedicle island flap, relieve pain, reduce adverse reactions, safe and effective, and worthy of clinical promotion.

Effect of vacuum sealing drainage combined with intermittent insulin flushing on expression of inflammatory factors and apoptosis factors in diabetic lower limb ulcer wound

Objective: To discuss the effect of vacuum sealing drainage combined with intermittent insulin flushing on the expression of inflammatory factors and apoptosis factors in diabetic lower limb ulcer wound. Methods: A total of 48 patients with diabetic lower limb ulcer who were treated in the Endocrine Department of the hospital between January 2016 and January 2017 were divided into the control group and research group by random number table, 24 cases in each group. Control group received vacuum sealing drainage, and research group received vacuum sealing drainage combined with intermittent insulin flushing. The differences in the expression of inflammatory factors and apoptosis genes in the wound exudate were compared between the two groups before and after treatment. Results: Before treatment, the differences in the inflammatory factor contents and apoptsis gene expression in wound exudate were not statistically significant between the two groups of patients. After treatment, inflammatory factors IL-6, IL-1β, TNF-α, CRP, VCAM-1 and FGF2 contents in wound exudate of research group were lower than those of control group;apoptosis gene Bcl-2 mRNA expression in wound exudate of research group was higher than that of control group while Bax, p53 and Fas mRNA expression were lower than those of control group. Conclusions: Vacuum sealing drainage combined with intermittent insulin flushing can effectively reduce the local inflammatory response and promote the granulation cell proliferation in wound of patients with diabetic lower limb ulcer.

Effect of Ilizarov external fixation combined with negative pressure sealing drainage and antibiotics in the treatment of infective tibial nonunion

Objective:Observation on the effect of Ilizarov external fixation combined with vacuum pressure sealing drainage and antibiotics in the treatment of infective tibial nonunion.Methods:79 patients with tibial infective nonunion who were treated in our hospital from August 2016 to August 2018 were divided into two groups according to random number table,with 39 patients in the control group treated with Ilizarov external fixation technology and 40 patients in the study group treated with vacuum pressure sealing drainage and antibiotics on the basis of the control group.Bone healing time and daily walking were recorded.Rasmussen score,serum intercellular adhesion molecule-1(ICAM-1)and IL-6 levels,lower limb Fugl-Meyer motor function score and lower limb BI index score were compared at different time.Results:The daily walking condition of the study group was significantly better than that of the control group(P<0.05),and the healing time of bone was significantly shorter than that of the control group(P<0.05);the Rasmussen score of the study group was higher than that of the control group at 1 month,6 months and 12 months after treatment(P<0.05);the levels of serum ICAM-1 and IL-6 in the two groups after treatment were lower than those before treatment(P<0.05),and the levels of serum ICAM-1 and IL-6 in the study group were lower than those in the control group after treatment(P<0.05).The lower limb Fugl-Meyer motor function score and lower limb BI index score of the two groups after treatment were higher than those before treatment(P<0.05),and the lower limb Fugl-Meyer motor function score and lower limb BI index score of the study group after treatment were higher than those of the control group(P<0.05).Conclusions:Ilizarov external fixation combined with vacuum pressure sealing drainage and antibiotics can promote the bone healing of patients with infective tibial nonunion,significantly improving their daily walking condition,alleviating inflammation,and recovering the knee joint function and lower limb function well.

老年营养风险指数、血清25羟维生素D水平与糖尿病足溃疡VSD治疗效果的关系

目的探讨老年营养风险指数(GNRI)、血清25羟维生素D[25(OH)D]水平与糖尿病足溃疡(DFU)患者负压封闭引流(VSD)治疗效果的关系。方法选取接受VSD术的DFU患者106例为DFU组,根据VSD治疗效果分为无效组(27例)和有效组(79例);同期另选取55例单纯2型糖尿病(T2DM)患者为单纯T2DM组,55名健康体检志愿者为对照组。计算GNRI,检测血清25(OH)D。用多因素Logistic回归分析DFU患者VSD治疗效果的影响因素,受试者工作特征曲线分析GNRI联合血清25(OH)D对DFU患者VSD治疗效果的评估价值。结果DFU组、单纯T2DM组、对照组GNRI、血清25(OH)D水平比较差异均有统计学意义(P均<0.05),三组GNRI、血清25(OH)D水平依次降低(P均<0.05)。Wagner分级4级、HbA1c升高为DFU患者VSD治疗无效的独立危险因素(P均<0.05),踝肱指数、GNRI、25(OH)D升高为DFU患者VSD治疗有效的独立保护因素(P均<0.05)。GNRI联合血清25(OH)D水平评估DFU患者VSD治疗效果的曲线下面积为0.879,大于二者单独评估的0.800、0.879(P均<0.05)。结论GNRI、血清25(OH)D水平低的DFU患者VSD治疗效果差,二者联合对DFU患者VSD治疗效果的评估价值较高。

复合皮移植联合VSD修复碾压伤致肘关节外露

目的:探讨复合皮移植联合负压封闭引流(Vacuum sealing drainage,VSD)在碾压伤伴关节外露创面修复中的临床应用效果及可行性。方法:2020年12月,笔者科室收治1例因左上肢车祸伤致皮肤坏死伴肿胀1 d的患者,入院时查体左上肢肿胀,左前臂、肘部可见约15.0 cm×20.0 cm皮肤坏死,左手感觉功能减退,桡动脉尚可触及,急诊手术探查见肘关节外露、脱位,肱三头肌自肱骨大范围撕脱,尺神经外露、移位,肘关节、尺骨外露范围约3.0 cm×5.0 cm。根据患者病史、临床表现、左上肢X线片及手术探查体征诊断左上肢碾压伤,肘关节外露。应用复合皮移植两步法联合VSD覆盖创面,自体中厚皮片移植修复皮肤缺损。结果:患者左上肢皮肤缺损处愈合良好,术后4个月复查,肘关节屈曲、伸直、旋转功能均恢复良好。结论:对于此例肘关节、骨外露创面,应用复合皮移植后可覆盖骨外露创面,大大降低了手术难度及患者的痛苦,为以后相对小面积骨外露创面的修复提供了新思路。

慢性难治性创口清创减张缝合VSD综合治疗方案临床分析

目的:分析27例通过清创减张缝合封闭式负压引流技术(VSD)综合治疗方案在解决慢性难治性创口术后愈合不良问题中应用的疗效。方法:回顾性分析27例2019年12月-2023年11月我院骨科应用VSD综合治疗方案治疗慢性难治性创口的临床资料,记录患者创面不愈合时间、VSD次数、愈合时间、血红蛋白含量、白蛋白含量,评估VSD综合治疗方案在治疗慢性难治性创口术后愈合不良问题中的作用。结果:共27例不同原因导致大面积或复杂创面不愈合的病人,在经过平均2.1次VSD引流术后采用多层减张缝合闭合创面。在入我科行VSD综合治疗后,创面愈合时间5-56(平均23.2)天,术后随访2-36月,伤口均愈合良好,无复发。结论:清创减张缝合VSD综合治疗方案在治疗慢性难治性创口术后愈合不良问题中有着良好的疗效。

The Application of Bilayer Artificial Dermis Combined with VSD Technology in Chronic Wounds

Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.

自制简易VSD装置联合MDT模式在难愈性创面治疗中的应用效果观察

目的:观察自制简易负压封闭引流(Vacuumsealingdrainage,VSD)装置联合多学科综合诊疗模式(Multidisciplinaryteam,MDT)在难愈性创面治疗中的疗效。方法:选取2020年1月-2022年5月笔者科室收治的60例各类难愈性创面患者,按照就诊时间先后顺序随机分为观察组和对照组,每组30例。对照组给予常规清创换药治疗,观察组清创后应用自制简易VSD装置联合MDT模式治疗。比较两组创面换药次数、治疗前后创面面积、愈合时间、疼痛评分、治疗有效率等。结果:治疗30 d后,观察组创面面积小于对照组(P<0.05)。治疗期间,观察组换药费用低于对照组(P<0.05);观察组创面愈合时间短于对照组(P<0.05);治疗2、4周后,观察组疼痛评分低于对照组(P<0.05);治疗4周后,观察组总有效率高于对照组(P<0.05)。结论:采用自制简易VSD联合MDT治疗难愈性创面效果显著,可减少换药频率,促进创面愈合,降低医疗费用。

基于创伤保护理念的VSD在骨髓炎伴骨缺损术后患者中的应用

目的探讨基于创伤保护理念的负压封闭引流术(VSD)在骨髓炎伴骨缺损术后患者中的应用效果。方法选取88例骨髓炎伴骨缺损术后患者,按照随机数字表法分成对照组和观察组,每组44例。对照组按照临床护理路径开展围手术期管理,观察组44例增加基于创伤保护理念的VSD。对比两组术后恢复状况、血清炎症指标、术后并发症及创面I期愈合率。结果观察组换药次数少于对照组,创面愈合时间、肉芽组织覆盖时间、抗生素使用时间、骨折愈合时间均短于对照组,差异有统计学意义(P<0.05)。干预后观察组白介素-6(IL-6)、白介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平均低于对照组(P<0.05)。观察组并发症发生率低于对照组,创面I期愈合率高于对照组(P<0.05)。结论基于创伤保护理念的VSD应用于骨髓炎伴骨缺损术后患者中可有效促进创面愈合,改善血清炎症指标,降低并发症风险。

VSD联合中厚皮片移植治疗糖尿病足慢性溃疡创面的效果

目的分析负压封闭引流技术(Vacuum sealing drainage,VSD)联合中厚皮片移植治疗糖尿病足慢性溃疡创面的临床效果。方法选取山东省阳谷县人民医院2022年4月-2023年1月收治的80例糖尿病足慢性溃疡患者作为研究对象,采取随机数字表法将患者分为对照组(n=40)和观察组(n=40),对照组实施常规中厚皮片移植治疗,观察组在对照组的基础上联合应用VSD治疗。比较两组患者临床指标、溃疡面积缩小率、肉芽组织生长情况、疼痛程度及瘢痕情况。结果观察组术后换药次数少于对照组,住院时间、创面愈合时间短于对照组,皮片成活率高于对照组(P<0.05)。观察组治疗2周和4周后溃疡面积缩小率及肉芽组织覆盖率均高于对照组(P<0.05)。观察组治疗3个月、6个月后VAS与VSS评分均低于对照组(P<0.05)。结论在糖尿病足慢性溃疡患者中应用VSD联合中厚皮片移植治疗效果显著,能够有效减少换药次数,促进创面愈合,提高皮片移植成活率,缩短住院时间、创面愈合时间,并降低患者疼痛及瘢痕情况。

VSD结合外固定术及皮瓣移植治疗开放胫腓骨骨折并软组织缺损的疗效

目的:观察负压封闭引流技术(Vacuum sealing drainage,VSD)结合外固定术及皮瓣移植治疗开放胫腓骨骨折并软组织缺损的效果。方法:选取2018年1月-2022年1月在笔者医院治疗的64例开放性胫腓骨骨折并软组织缺损患者作为研究对象,按照随机数字表法将其分为观察组与对照组各32例。对照组给予传统换药+外固定术+二期皮瓣移植治疗,观察组给予VSD+外固定术+二期皮瓣移植治疗,两组二期手术均在创面肉芽组织生长满意后进行。一期治疗后7 d后,比较两组创面指标(创面细菌清除率、创面肉芽组织覆盖率、创面组织液分压、肉芽组织生长良好时间)及治疗前后血清炎性因子[白介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平;二期术后3个月,评估两组临床疗效,比较两组踝关节活动度、踝关节功能及并发症。结果:一期治疗7 d后,观察组创面细菌清除率、创面肉芽组织覆盖率、创面组织液分压均高于对照组(P<0.05),观察组肉芽组织生长良好时间短于对照组(P<0.05)。治疗前,两组血清炎性因子IL-6、CRP、TNF-α比较差异无统计学意义(P>0.05);治疗7 d后,观察组患者血清IL-6、CRP、TNF-α水平低于对照组(P<0.05)。二期术后3个月,观察组临床总有效率93.75%高于对照组的68.75%(P<0.05)。二期术后3个月,观察组踝关节活动度、关节功能评分(足部对线、地面步行、疼痛、最大步行距离)均高于对照组(P<0.05)。治疗期间,观察组并发症总发生率低于对照组(P<0.05)。结论:VSD结合外固定术及皮瓣移植治疗开放胫腓骨骨折并软组织缺损,可有效清除创面细菌,降低炎性因子水平,促进创面愈合及早期关节功能恢复。

VSD联合银离子敷料治疗慢性创面的疗效观察及护理探讨

目的:分析负压封闭引流技术(VSD)联合银离子敷料治疗慢性创面的疗效及相关护理对策。方法:选取2019年4月-2020年4月于笔者医院诊治的72例慢性创面患者为研究对象,所有受试对象入院后均给予彻底清创及内科治疗,在此基础上采用VSD联合银离子敷料治疗,并予以优质护理。评估临床疗效,记录治疗期间肉芽形成时间、创面愈合时间及住院治疗时间。分别于治疗前、治疗7 d、14 d和28 d后对创面进行细菌培养,并分析细菌培养结果。结果:72例患者中显效21例(21/72,29.17%),有效45例(45/72,62.50%),无效6例(6/72,8.33%),临床有效率为91.67%(66/72)。患者肉芽组织形成时间为(10.06±2.48)d,创面愈合时间为(36.15±2.87)d,住院治疗时间为(23.12±5.47)d。患者治疗7 d、14 d和28 d创面细菌培养阳性率均低于治疗前,治疗14 d和28 d创面细菌培养阳性率均低于治疗7 d,治疗28 d创面细菌培养阳性率均低于治疗14 d(P<0.05)。结论:VSD联合银离子敷料治疗慢性创面疗效好,能够有效促进肉芽组织生成和创面愈合,减轻细菌感染,值得推广。

VSD联合肌皮瓣移植术对胫骨开放性骨折继发感染患者细胞因子、炎性因子及功能恢复的影响

目的分析持续负压封闭引流技术(VSD)联合肌皮瓣移植术对胫骨开放性骨折继发感染患者细胞因子、炎性因子及功能恢复的影响。方法回顾性分析2017年3月—2021年11月诊治126例胫骨开放性骨折继发感染的临床资料,根据治疗方案分为研究组65例和对照组61例。研究组采用VSD联合肌皮瓣移植术治疗,对照组采用传统皮瓣移植术治疗。对比2组手术前后细胞因子[细胞间黏附因子-1(ICAM-1)、可溶性血管细胞黏附因子-1(sVCAM-1)、核因子-κB(NF-κB)]、炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-8(IL-8)、IL-10]水平以及术后功能恢复情况。结果术后15 d,2组ICAM-1、sVCAM-1、NF-κB、hs-CRP、TNF-α、IL-8、IL-10水平均较术前升高,但研究组上述指标水平均低于对照组(P<0.05)。术后,研究组疼痛数字评分法(NRS)评分低于对照组,骨折愈合时间、部分负重时间、完全负重时间及住院时间短于对照组(P<0.01)。与对照组比较,研究组足功能恢复优良率更高(P<0.05)。结论VSD联合肌皮瓣移植术治疗对胫骨开放性骨折继发感染患者足功能恢复有积极影响,还能改善机体细胞因子及炎性因子水平。

黄连解毒汤联合VSD对深Ⅱ度烧伤患者临床疗效、炎症因子的影响

目的:分析黄连解毒汤联合负压封闭引流(VSD)对深Ⅱ度烧伤患者炎症因子及临床疗效的影响。方法:选择2022年7月—2023年1月在九江市第一人民医院接受治疗的120例深Ⅱ度烧伤患者,按随机数字表法分为两组。对照组(n=60)实施VSD治疗,试验组(n=60)在对照组的基础上给予黄连解毒汤治疗。比较两组临床疗效、恢复情况、血清炎症因子表达水平及视觉模拟评分法(VAS)评分。结果:试验组总有效率为95.00%,明显高于对照组的81.67%(P<0.05);与对照组相比,试验组创面渗液干净时间、创面愈合时间、住院时间均更短(P<0.05);两组治疗后的C反应蛋白(CRP)、白细胞介素-6(IL-6)、CD64均低于治疗前,且试验组均低于对照组(P<0.05);试验组治疗7、14、21 d后的VAS评分均低于对照组(P<0.05)。结论:黄连解毒汤联合VSD可降低深Ⅱ度烧伤患者炎症因子的表达水平,缓解患者疼痛,促进创面恢复。

水凝胶敷料配合VSD技术对复杂四肢骨折术后创面愈合的影响研究

目的 探析水凝胶敷料配合负压封闭引流技术(VSD技术)对复杂四肢骨折术后创面愈合的影响。方法 92例复杂四肢骨折患者,采用交替分组法分为对照组和观察组,每组46例。对照组患者术后应用VSD技术进行干预,观察组患者术后应用水凝胶敷料配合VSD技术进行干预。比较两组换药次数、创面愈合时间,治疗效果,血清炎症因子(白细胞介素-8、白细胞介素-6与肿瘤坏死因子-α)水平。结果 两组患者的换药次数比较,差异无统计学意义(P>0.05);观察组患者的创面愈合时间(14.65±2.14)d短于对照组的(22.52±3.50)d,差异有统计学意义(P<0.05)。观察组治疗总有效率95.65%高于对照组的78.26%,差异有统计学意义(P<0.05)。观察组患者的白细胞介素-8、白细胞介素-6与肿瘤坏死因子-α水平分别为(0.70±0.15)、(0.60±0.08)、(0.72±0.06)ng/L,均低于对照组的(1.30±0.32)、(0.99±0.15)、(0.90±0.13)ng/L,差异有统计学意义(P<0.05)。结论 复杂四肢骨折属于骨科诊室的常见病,术后予以患者水凝胶敷料配合VSD技术可进一步保证预后,既可促进创面快速愈合,又能改善患者机体炎性反应,符合临床治疗需求。