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中华损伤与修复杂志(电子版) ›› 2020, Vol. 15 ›› Issue (01) : 56 -60. doi: 10.3877/cma.j.issn.1673-9450.2020.01.009

所属专题: 文献

论著

皮肤持续牵张技术联合负压封闭引流技术治疗深度创面的临床观察
王志强1, 李智1,()   
  1. 1. 030032 山西白求恩医院急救医学科
  • 收稿日期:2019-12-23 出版日期:2020-02-01
  • 通信作者: 李智
  • 基金资助:
    山西省重点研发计划项目(201803D31141)

Clinical observation of continuous skin distraction technique combined with vacuum sealing drainage in the treatment of deep wounds

Zhiqiang Wang1, Zhi Li1,()   

  1. 1. Department of Emergency Medicine, Shanxi Bethune Hospital, Taiyuan 030032, China
  • Received:2019-12-23 Published:2020-02-01
  • Corresponding author: Zhi Li
  • About author:
    Corresponding author: Li Zhi, Email:
引用本文:

王志强, 李智. 皮肤持续牵张技术联合负压封闭引流技术治疗深度创面的临床观察[J]. 中华损伤与修复杂志(电子版), 2020, 15(01): 56-60.

Zhiqiang Wang, Zhi Li. Clinical observation of continuous skin distraction technique combined with vacuum sealing drainage in the treatment of deep wounds[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2020, 15(01): 56-60.

目的

探讨皮肤持续牵张技术联合负压封闭引流(VSD)技术治疗深度创面的临床疗效。

方法

选取2015年5月至2018年5月山西白求恩医院急救医学科收治的不同部位深度创面患者20例,其中外伤10例,压疮7例,感染创面3例。根据创面情况实施清创术后应用皮肤持续牵张联合VSD治疗,观察并记录患者伤口愈合时间,使用温哥华瘢痕量表评估创面愈合质量。

结果

20例患者经皮肤持续牵张与VSD治疗后,创面均愈合良好,无愈合不良或不愈合。创面大小为2 cm×2 cm~3 cm×4 cm的5例患者创面平均愈合时间为20 d,创面大小为5 cm×5 cm~8 cm×10 cm的8例患者创面平均愈合时间为22 d,创面大小为10 cm×15 cm~15 cm×20 cm的7例患者创面平均愈合时间为30 d。创面愈合后3个月随访所有患者温哥华瘢痕量表评分平均为3.8分。

结论

应用皮肤持续牵张技术与VSD技术联合治疗深度创面不仅可以获得满意的临床效果,而且具有操作简单、创伤小等优点,值得推广。

Objective

To investigate the clinical effect of continuous skin distraction technique combined with vacuum sealing drainage (VSD) on the treatment of deep wounds.

Methods

From May 2015 to May 2018, 20 patients with deep wound in different parts were selected from the Department of Emergency Medicine, Shanxi Bethune hospital, including 10 cases of trauma, 7 cases of pressure sore and 3 cases of infection wound. According to the situation of wounds, continuous skin distraction combined with VSD was applied after debridement. The wound healing time was observed and recorded. The Vancouver scar scale of all the patients was used to evaluate the wound healing quality.

Results

The wounds of 20 patients were healed well after continuous stretch of skin and VSD treatment. The average healing time of 5 patients with wound size of 2 cm×2 cm to 3 cm×4 cm was 20 days, the average healing time of 8 patients with wound size of 5 cm×5 cm to 8 cm×10 cm was 22 days, and the average healing time of 7 patients with wounds ranging from 10 cm×15 cm to 15 cm×20 cm was 30 days. The average vancouver scar scale score of 3 months after wound healing was 3.8 point.

Conclusion

The application of continuous skin distraction combined with VSD technology to treat deep wounds not only can obtain satisfactory clinical results, but also has the advantages of simple operation and small trauma, which is worth promoting.

图1 采用皮肤持续牵张技术联合VSD技术治疗骶尾部压疮。A示患者骶尾部压疮大小为10 cm×15 cm,表皮已发黑,外周红肿。B示给予清创术+VSD治疗。C示创面基底肉芽组织形成,给予清创术+皮肤持续牵张技术+VSD。D示经过2次清创术+VSD及2次清创术+皮肤持续牵张技术+VSD,距离第1次手术39 d后,拆除VSD装置可见创面愈合良好。VSD为负压封闭引流
图2 采用皮肤持续牵张技术联合VSD技术治疗右前臂血肿。A示右前臂血肿切开术后创面愈合不良,大小为8 cm×5 cm。B示第1次清创术后VSD装置覆盖创面。C示术后1周行第2次清创术+皮肤持续牵张技术+VSD。D示术后11天拆开VSD装置,创面愈合良好,给予皮肤牵张缝合器继续加固。VSD为负压封闭引流
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