摘要
目的 探讨负压封闭技术 (VS)治疗创伤后软组织缺损的疗效。方法 42例 (48个创面 )接受VS治疗 ,清创后将威克伤 (Vacuseal)材料覆盖在相应大小的创面上或创腔内 ,维持负压在 50～ 60kPa之间 ,5～ 7天后二期缝合、植皮或皮瓣转移。结果 42例完全治愈 ,无全身和局部并发症。与传统换药方法比较 ,在二期缝合的时间、换药次数、创面缩小程度及总体治疗费用等方面均有显著差异 (P <0 .0 1 )。 48个创面中 ,直接通过VS治愈 6个 ,采用游离皮瓣关闭 4个 ,局部转移皮瓣关闭 8个 ,植皮关闭 2 5个 ,二期缝合 5个。结论 VS治疗能防止创面污染、充分引流、剌激创面肉芽生长、缩短疗程和消除感染。对创伤后急、慢性软组织缺损是一种简单、有效的治疗方法。
Objective To investigate the management of posttraumatic soft tissue defects by vacuum sealing technique(VS).?Methods Forty two cases patients with 48 posttraumatic soft tissue defects were treated by the VS following debridement and compared with 126 patients managed by traditional dressing (control group). Wound surface or cavities were filled with polyvinyl alcohol foams with embedded drainage tubes connected with vacuum bottle (negative pressure of 50 to 60 kPa). Wound closure was performed with secondary suturing, or free flap, or loco regional flap and mesh grafts after 5 and 7 days.?Results Forty two cases recovered. No complications (systemic and located) were found. The average time of VS was 7.5 days. There was significant difference between 2 groups in time of secondary closure, times of dressing and decreased the dimensions of the initial wound, total cost of treatment (P<0.01). Wound closure was performed in 4 cases with a free flap, by a loco regional (n=8), or by secondary suturing (n=5), by skin grafting (n=25). Six cases were definitively treated with VS.?Conclusion The VS procedure can protect against wound contamination,result in complete evacuation of wound fluids and rapid simulation of dense, well vascularized granulation tissue,thus shortening healing time and eradicating any pre existing infection. The VS is a simple and effective method in treatment of traumatic and chronic soft tissue defects.
出处
《创伤外科杂志》
2002年第1期9-12,共4页
Journal of Traumatic Surgery
关键词
创伤
负压封闭技术
软组织缺损
trauma
vacuum sealing technique
soft-tissue defects
