间歇对流冲洗负压封闭引流技术治疗老年难愈性创口36例

摘要

目的：观察负压封闭引流技术（ Vacuum Sealing Drainage，VSD）治疗老年难愈性创口的临床疗效。方法对2013年6月～2014年6月骨伤科收治的36例因车祸、重物砸伤等原因造成的皮肤软组织缺损或骨外露患者，通过手术清创、骨折复位固定后将VSD系统覆盖于创面上，间歇对流冲洗持续负压引流治疗，视创口愈合情况更换负压封闭引流材料，直至肉芽生长良好。结果经间歇对流冲洗负压封闭引流技术治疗后35例患者创面肉芽组织新鲜，局部血液循环较好，17例行自体皮片移植，18例单纯VSD治疗，1例因钢板轻微外露，植皮难以存活，二期行皮瓣修复术，术后恢复良好。3个月后随访创口治愈率达100％。结论间歇对流冲洗负压封闭引流技术治疗老年难愈性创口疗效显著，有创口恢复快、感染率低、减轻患者痛苦等优势。%Objective To analyze retrospectively the efficacy of negative pressure drainage technology ( vacuum sealing drain-age, the VSD) for elderly painless sexual trauma.Methods 36 patients admitted in our hospital orthopedics caused by car accidents with weight parts of skin and soft tissue defect, or bone exposed patients in June 2013 to June 2014, through surgical debridement, re-duction and fixation of fracture.VSD system covered the wound, continuing the negative pressure drainage treatment according to the condition of wound healing.We replaced the closed negative pressure drainage materials, until the granulation grow well.Results After treatment for closed negative pressure drainage technology of 35 patients, the wound granulation tissue become fresh, and local blood circulation was better.17 patients underwent autologous skin graft surgery, and 18 patients underwent VSD therapy.Skin graft in one patient is difficult to survive, because the steel plate slight leakage.AfterⅡ'skin flap repair, it recoved well.The wound cure rate was 100% by follow-up after 3 month.Conclusion The curative effect of the negative pressure drainage technology in treat-ment elderly painless trauma is distinct, and it can reduce the patient's pain.It also have sealed quick recovery and low infection rate.