目的 观察应用负压封闭引流(VSD) 技术联合游离髂腹股沟皮瓣移植修复治疗上肢毒蛇咬伤后坏死创面的效果.方法 对17例上肢毒蛇咬伤后皮肤坏死患者先行感染创面清创加VSD持续冲洗及负压引流处理,然后选择游离髂腹股沟皮瓣移植修复; 切取游离皮瓣大小为8 cm × 13 cm ～ 14 cm × 19 cm.结果 17例中2例皮瓣术后出现部分边缘坏死,经局部换药后创面逐渐愈合,其余15例皮瓣完全成活,皮瓣外观及质地满意,患肢活动功能恢复良好.结论 应用VSD技术联合游离髂腹股沟皮瓣移植修复治疗上肢毒蛇咬伤后坏死创面取得良好的临床效果,是理想的治疗方法.%Objective To investigate the clinical application of VSD technique combined with free groin flap transplantation in treatment of necrotic wounds after snakebite at upper limbs. Methods Debridement and VSD continuous irrigation and negative pressure were performed on the patients with skin necrosis after snakebite at upper limbs,then free groin flaps were transplanted to repair the wounds. The sizes of free flaps were 8 cm × 13 cm to 14 cm × 19 cm. Results Of the 17 cases performed skin transplantation,2 cases had partial necrosis and their wounds healed gradually after local dressing,the rest 15 cases had completely successful operation with satisfying flap appearance and texture,and well recovered limb function. Conclusion VSD technique combined with free groin flap transplantation is an ideal method of treatment for necrotic wounds after snakebite at upper limbs.
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