| VSD技术结合冰石愈伤软膏治疗足部皮肤缺损 |
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投稿时间：2020-04-25
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| 作者 | Author | 单位 | Address | E-Mail |
| 白文博 |
BAI Wen-bo |
陕西中医药大学, 陕西 咸阳 712046 |
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| 张若肖 |
ZHANG Ruo-xiao |
陕西中医药大学, 陕西 咸阳 712046 |
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| 徐军奎 |
XU Jun-kui |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shannxi, China |
568720818@qq.com |
| 鹿军 |
LU Jun |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shannxi, China |
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| 梁晓军 |
LIANG Xiao-jun |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shannxi, China |
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| 王军虎 |
WANG Jun-hu |
西安交通大学附属红会医院足踝外科, 陕西 西安 710054 |
Foot and Ankle Surgery, Honghui Hospital Affiliated to Xi'an Jiaotong University, Xi'an 710054, Shannxi, China |
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| 期刊信息：《中国骨伤》2020年，第33卷，第9期，第873-877页 |
| DOI：10.12200/j.issn.1003-0034.2020.09.016 |
| 基金项目: |
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中文摘要:目的：探讨负压封闭引流（vacuum sealing drainage，VSD）技术与冰石愈伤软膏换药治疗足部皮肤缺损的临床疗效。
方法：2017年11月至2019年4月，采用VSD技术与冰石愈伤软膏换药治疗21例（21足）足部皮肤缺损的患者，男17例，女4例；年龄24~60（37.8±11.2）岁；车祸伤9例，重物砸伤6例，高处坠落伤6例；损伤至手术时间3~36（8.6±7.2）h；足部皮肤缺损面积20.35~83.43（47.2±19.5）cm2。所有患者急诊行清创或I期临时固定，利用Mimics软件对患足进行三维成像，并渲染缺损面积。观察创面愈合的质量及并发症，按Maryland足功能评分标准评价临床疗效。
结果：21例患者获得随访，时间7~17（10.8±2.7）个月。术后创面无合并感染、不愈合的发生。末次随访时创面皮缘生长紧密、皮肤弹性可，质地韧，外观无明显臃肿。创面愈合时间18~63（41.2±13.3）d。8例患者行Ⅱ期固定或（与）融合术，切口均Ⅰ期愈合。Maryland足部评分为89.0±6.8，其中优9例，良11例，中1例。
结论：VSD技术可有效清除创面坏死组织，提供引流通畅的创面，联合冰石愈伤软膏预防感染，促进肉芽组织迅速生长，治疗周期短，创面愈合部位质量高，患肢功能良好，临床疗效满意。 |
| 【关键词】负压封闭引流 冰石愈伤软膏 足部皮肤缺损 |
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| VSD technique combined with Bing Shi Yu Shang Ointment for the treatment of foot skin defects |
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ABSTRACT Objective: To explore the clinical effect of vacuum sealing drainage (VSD) technique and Bing Shi Yu Shang Ointment in the treatment of foot skin defect.
Methods: From November 2017 to April 2019,21 patients (21 feet) with foot skin defect were treated with VSD technique and Bing Shi Yu Shang Ointment. There were 17 males and 4 females,aged from 24 to 60 years old with an average of (37.8±11.2) years,9 cases caused by traffic accident injury,6 cases by heavy injury,6 cases by falling injury. The time from injury to operation was for 3 to 36 (8.6±7.2) h,and the area of foot skin defect was for 20.35 to 83.43 (47.2±19.5) cm2. All patients underwent debridement or phaseⅠtemporary fixation in emergency,and three-dimensional imaging of the foot was performed by using Mimics software,and the defect area was rendered. The quality of wound healing and complications were observed,and the clinical effect was evaluated by Maryland foot function score.
Results: All the 21 patients were followed up for 7 to 17 (10.8±2.7) months. There was no infection or nonunion in all patients. At the final follow-up,the skin margin of the healing site grew tightly,the skin was elastic,the texture was tough,the appearance was no obvious carbuncle. The time of wound healing was for 18 to 63 (41.2±13.3) days. Eight patients underwent stageⅡfixation or/and fusion,and all incisions healed by stageⅠ. According to Maryland's foot scoring,9 cases got excellent results,11 good,and 1 middle.
Conclusion: VSD can effectively remove the necrotic tissue of the wound,provide a smooth drainage of the wound,combine with Bing Shi Yu Shang Ointment to prevent infection and promote the rapid growth of granulation tissue,whose whole treatment cycle was short,the wound healing site was high quality,the limb function was good,and the clinical effect was satisfactory. |
| KEY WORDS Vacuum sealing drainage Bing Shi Yu Shang Ointment Foot skin defect |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 白文博,张若肖,徐军奎,鹿军,梁晓军,王军虎.VSD技术结合冰石愈伤软膏治疗足部皮肤缺损[J].中国骨伤,2020,33(9):873~877 |
| 英文格式: | BAI Wen-bo,ZHANG Ruo-xiao,XU Jun-kui,LU Jun,LIANG Xiao-jun,WANG Jun-hu.VSD technique combined with Bing Shi Yu Shang Ointment for the treatment of foot skin defects[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(9):873~877 |
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