简易封闭式负压引流治疗35例汶川地震伤员创面的效果分析
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摘要
目的探讨简易封闭式负压引流技术治疗地震伤员创面的疗效。方法回顾性分析使用简易封闭式负压引流技术治疗35例汶川地震伤员的临床资料,并与2008年1月1日至5月1日收治的采用常规治疗的同类型患者35例对照,比较治疗效果。结果封闭式负压组伤员经治疗6～12天(平均7.5±1.8天)后,创面达到Ⅱ期闭合条件。创面全部治愈,其中植皮覆盖24处、Ⅱ期缝合4处、局部皮瓣转移修复5处、交腿皮瓣修复2处。与常规治疗比较,两组在Ⅱ期缝合、植皮或皮瓣转移的时间、换药次数及住院时间等方面差异均有统计学意义(P<0.01)。Ⅱ期后续植皮疗效差异也有统计学意义(P<0.05)。结论简易封闭式负压引流技术能缩短创面Ⅱ期处理时间、促进创面愈合、减少换药次数及材料耗费、有利于Ⅱ期所植皮片成活;在紧急情况下,VSD敷料及生物透性薄膜价格昂贵且有限,简易封闭式负压引流技术是一种简单、安全、有效的应急治疗方法,且可降低成本。
Objective To investigate the curative effect of facility negative pressure closed drainage on wounds in earthquake.Methods We retrospectively analyzed the data of 35 patients treated by facility negative pressure closed drainage after debridement in earthquake.The same category patients treated by conventional therapy as the control group.Results Time of facility negative pressure closed drainage was 6-12 days,average 7.5±1.8 days.The wounds were all cured.The wounds closure were performed with skin grafting in 24,with secondary suturing in 4,with regional flap transposition in 5,and with cross leg flap in 2.There were significant differences in time of secondary closure,times of dressing and the total time of hospitalization between two groups(P<0.01).And there was a significant difference in curative effect of skin grafting between two groups(P<0.05).Conclusion Facility negative pressure closed drainage on treating wounds in earthquake is a simple,safe method,and has significant curative effect.
Objective To investigate the curative effect of facility negative pressure closed drainage on wounds in earthquake.Methods We retrospectively analyzed the data of 35 patients treated by facility negative pressure closed drainage after debridement in earthquake.The same category patients treated by conventional therapy as the control group.Results Time of facility negative pressure closed drainage was 6-12 days,average 7.5±1.8 days.The wounds were all cured.The wounds closure were performed with skin grafting in 24,with secondary suturing in 4,with regional flap transposition in 5,and with cross leg flap in 2.There were significant differences in time of secondary closure,times of dressing and the total time of hospitalization between two groups(P<0.01).And there was a significant difference in curative effect of skin grafting between two groups(P<0.05).Conclusion Facility negative pressure closed drainage on treating wounds in earthquake is a simple,safe method,and has significant curative effect.
引文
1裘华德.负压封闭引流技术.第1版.北京:人民卫生出版社,2003,24-230.
2Fleischmann W,Strecker W,Bombelli M.Vacuum sealing as treatment of soft tissue damage in open fractures.Unfallchirurg,1993,96(9):488-492.
3Huang WS,Hsieh SC,Hsieh CS,et a1.Use of vacuum-assisted wound closure to manage limb wounds in patients suffering from acute necrotizing fasciitis.Asian Surg,2006,29(3):135-139.
4黄显凯,姚元章,王韬.负压封闭引流在严重多发伤创面治疗中的作用.创伤外科杂志,2008,10(5):437-439.
5Morykwas MJ,Argenta LC,Shelton-Brown EI,et a1.Vacuum-assisted closure:a new method for wound control and treatment:animal studies and basic foundation.Ann Plast Surg,1997,38(6):553-562.
6Banwell PE.Topical negative pressure therapy in wound care.Wound Care,1999,8(2):79-84.
7沈波,廖苏平,吴波.韧厚皮片结合封闭式负压吸引治疗感染性大面积皮肤缺损.临床外科杂志,2007,15(7):497.
8聂兰军,宋辉,蔡薇.负压创面治疗技术的研究进展.感染、炎症、修复,2008,9(3):191-192.
2Fleischmann W,Strecker W,Bombelli M.Vacuum sealing as treatment of soft tissue damage in open fractures.Unfallchirurg,1993,96(9):488-492.
3Huang WS,Hsieh SC,Hsieh CS,et a1.Use of vacuum-assisted wound closure to manage limb wounds in patients suffering from acute necrotizing fasciitis.Asian Surg,2006,29(3):135-139.
4黄显凯,姚元章,王韬.负压封闭引流在严重多发伤创面治疗中的作用.创伤外科杂志,2008,10(5):437-439.
5Morykwas MJ,Argenta LC,Shelton-Brown EI,et a1.Vacuum-assisted closure:a new method for wound control and treatment:animal studies and basic foundation.Ann Plast Surg,1997,38(6):553-562.
6Banwell PE.Topical negative pressure therapy in wound care.Wound Care,1999,8(2):79-84.
7沈波,廖苏平,吴波.韧厚皮片结合封闭式负压吸引治疗感染性大面积皮肤缺损.临床外科杂志,2007,15(7):497.
8聂兰军,宋辉,蔡薇.负压创面治疗技术的研究进展.感染、炎症、修复,2008,9(3):191-192.
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