| 负压封闭引流在开放性足踝部骨折脱位中的应用 |
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Received:April 01, 2012
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| 作者 | Author | 单位 | Unit | E-Mail |
| 黄雷 |
HUANG Lei |
宁波市第六医院足踝外科, 浙江 宁波 315040 |
Department of Foot & Ankle Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
wyklwyjk@163.com |
| 张锋 |
ZHANG Feng |
宁波市第六医院足踝外科, 浙江 宁波 315040 |
Department of Foot & Ankle Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 叶鹏翰 |
YE Peng-han |
宁波市第六医院足踝外科, 浙江 宁波 315040 |
Department of Foot & Ankle Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 何贤峰 |
HE Xian-feng |
宁波市第六医院足踝外科, 浙江 宁波 315040 |
Department of Foot & Ankle Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 朱彦昭 |
ZHU Yan-zhao |
宁波市第六医院足踝外科, 浙江 宁波 315040 |
Department of Foot & Ankle Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 阮永平 |
RUAN Yong-ping |
宁波市第六医院足踝外科, 浙江 宁波 315040 |
Department of Foot & Ankle Surgery, Ningbo No.6 Hospital, Ningbo 315040, Zhejiang, China |
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| 期刊信息：《中国骨伤》2012年25卷，第8期，第651-653页 |
| DOI：10.3969/j.issn.1003-0034.2012.08.009 |
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目的:探讨负压封闭引流(vacuum sealing drainage,VSD)技术治疗足踝部外伤后软组织缺损伴肌腱与骨外露的疗效。
方法:2007年10月至2011年2月对397例(412足)开放性足踝部骨折、脱位伴软组织缺损患者采用VSD技术治疗。其中男301例,女96例;年龄20～73岁,平均36岁。按AO软组织损伤分型:Ⅰ型74足,Ⅱ型211足,Ⅲ型108足,Ⅳ型19足。 受伤至手术时间2～12 h,平均5.6 h,平均治疗时间10个月(4～19个月).
结果:141例创面Ⅰ期愈合,97例Ⅱ期缝合;103例行Ⅱ期全厚皮片植皮术,25例行游离皮瓣转移术。术后感染34例,因感染拆除钢板3例。14例因第1跖骨外露,行剔骨皮瓣覆盖创面。22例因足趾坏死截趾术,10例前足坏死行跖附关节离断术。术后创面渗血3例。306例患者均获得随访,平均随访时间为10个月(3～20个月),创面愈合良好。
结论:VSD技术治疗足踝部外伤后软组织缺损是简单、安全有效的方法,但不能代替清创和皮瓣转移。 |
| [关键词]:引流术 踝关节 骨折 脱位 软组织损伤 |
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| Application of vacuum sealing drainage in open ankle fracture and dislocation |
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Abstract:
Objective:To investigate therapeutic effects of vacuum sealing drainage(VSD) in the treatment of soft tissue defect combined with tendon and bone exposure.
Methods:From October 2007 to February 2011,397 patients (412 feet) with open ankle fracture and dislocation combined with soft tissue defected were treated by VSD. There were 301 males and 96 females with an average age of 36 years(ranging age from 20 to 73 years). According to AO classification,74 feet were type Ⅰ,211 feet were type Ⅱ,108 feet were type Ⅲ and 19 feet were type Ⅳ。 The mean time from injury to operation was 5.6 h( 2 to 12 h). The mean treatment time of was 10 months(4 to 19 months).
Results:One hundred and forty-one patients were primarily healed,97 patients were sutured at stage II. Split-thick skin grafting was performed at stageⅡwas performed in 103 patients;free flap transplantation was performed in 25 patients. Three of the 34 patients with infection were removed steel plate; Eviscerate flap coverage wound was performed in 14 patients caused by the first metatarsal bone exposure;Toe amputation were performed in 22 cases caused by toes necrosis. Tarsometatarasl joints perforators' surgery was performed in 10 patients with forefeet necrosis. Thirty hundred and six patients were followed up from 3 to 20 months(averaged 10 months). The wounds healed well.
Conclusion:VSD for soft tissue defects caused by ankle injury is a simple and effective method,but can not replace debridement and transfer flap. |
| KEYWORDS:Drainage Ankle joint Fractures Dislocations Soft tissue injuries |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄雷,张锋,叶鹏翰,何贤峰,朱彦昭,阮永平.负压封闭引流在开放性足踝部骨折脱位中的应用[J].中国骨伤,2012,25(8):651~653 |
| 英文格式: | HUANG Lei,ZHANG Feng,YE Peng-han,HE Xian-feng,ZHU Yan-zhao,RUAN Yong-ping.Application of vacuum sealing drainage in open ankle fracture and dislocation[J].zhongguo gu shang / China J Orthop Trauma ,2012,25(8):651~653 |
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