| 负压封闭引流结合灌洗技术在骨科开放性创面治疗中的应用 |
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Received:November 20, 2015
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| 作者 | Author | 单位 | Unit | E-Mail |
| 徐卫国 |
XU Wei-guo |
天津医院, 天津 300000 |
Tianjin Hospital, Tianjin 300000, China |
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| 王晓卫 |
WANG Xiao-wei |
天津中医药大学, 天津 300000 |
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| 万春友 |
WAN Chun-you |
天津医院, 天津 300000 |
Tianjin Hospital, Tianjin 300000, China |
wanchunyouxs@163.com |
| 刘磊 |
LIU Lei |
天津中医药大学, 天津 300000 |
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| 全先辉 |
QUAN Xian-hui |
天津中医药大学, 天津 300000 |
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| 杨光 |
YANG Guang |
天津中医药大学, 天津 300000 |
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| 朱旭伟 |
ZHU Xu-we |
天津医科大学, 天津 300000 |
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| 期刊信息：《中国骨伤》2016年29卷，第4期，第325-328页 |
| DOI：10.3969/j.issn.1003-0034.2016.04.008 |
| 基金项目:天津市卫生局科技基金(编号:13KG129) |
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目的:探讨负压封闭引流结合灌洗技术在骨科开放性创面治疗中的优越性.
方法:回顾分析2012年6月至2014年10月治疗的49例56处四肢开放性创面患者,24例25处创面采用常规负压封闭引流技术(vacuum sealing drainage,VSD)治疗(对照组),男18例,女6例;年龄24~56岁,平均(41.3±9.0)岁;GustiloⅡ型13处,ⅢA型8处,ⅢB型4处.25例31处创面采用VSD结合单管闭式灌洗引流技术治疗(治疗组),男21例,女4例;年龄23~55岁,平均(42.2±9.1)岁;GustiloⅡ型15处,ⅢA型10处,ⅢB型6处.两组患者术前均存在严重的皮肤软组织开放性损伤,以单次VSD和抗生素的使用时间、总住院天数作为临床观察指标.以创面肉芽组织生长及Ⅱ期创面愈合情况进行临床评价.
结果:49例患者获随访,时间8~23个月,平均14个月.治疗组创面肉芽组织生长情况及坏死组织清除率优于对照组,抗生素应用率降低,治疗组单次VSD使用时间延长,堵管及更换次数减少,促进了创面的愈合,缩短了Ⅱ期关闭创面、植皮或游离皮瓣转移治疗的时间,减少了总住院天数.
结论:VSD结合单管闭式灌洗引流技术,可以减少术后抗生素的使用,延长单次VSD的使用时间,进一步清除创腔及创面的坏死组织,促进肉芽组织的生长和创面的愈合. |
| [关键词]:持续灌洗 负压封闭引流 开放性创面 |
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| Clinical application of vacuum sealing drainage combined with closed continuous irrigation in treatment of the orthopaedic open wounds |
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Abstract:
Objective:To discuss the advantage of the vacuum sealing drainage with closed continuous irrigation in treatment of the orthopaedic open wounds.
Methods:A retrospective analysis was performed in 49 patients who had 56 open wounds of the limbs from June 2012 to October 2014. Among them,24 patients who had 25 open wounds were treated with vacuum sealing drainage(VSD) as control group,including 18 males and 6 females with an average age of (41.3±9.0) years old ranging from 24 to 56 years;according to Gustilo classification,13 wounds were type Ⅱ,8 wounds were type ⅢA and 4 wounds were type ⅢB. Other 25 patients who had 31 open wounds were treated with the VSD and closed continuous irrigation as treatment group, including 21 males and 4 females with an average age of (42.2±9.1) years old ranging from 23 to 55 years; 15 wounds were Gustilo type Ⅱ,10 wounds were type ⅢA and 6 wounds were type ⅢB. The patients of two groups both had the serious open injury of the soft tissue. The use time of VSD per once,antibiotic use time,VSD replace number and the total hospitalization days were observed as the clinical indicators. The growth of granulation tissue and the wound healing of second phase were recorded as the clinical evaluation.
Results:All patients were followed up for 8 to 23 months with an average of 14 months. The wound granulation tissue growth and necrotic tissue clearance of treatment group was better than those of the control group. The antibiotics usage ratio of treatment group decrease. As compared with control group,in the treatment group the use time of VSD per once extended and the times of drainage tube blockage decreased,the replacement times of VSD were reduced. In the treatment group,the wound healing was promoted and the time of second stage to close wounds,skin graft or free flap transfer were shortened. The hospital stays of treatment group were decreased.
Conclusion:The VSD with closed continuous irrigation for treatment of the orthopaedic open wounds can reduce the use of antibiotics and extend the time of the VSD per once,to remove the cavity and necrotic tissue and promote the growth of granulation tissue and wound healing. |
| KEYWORDS:Continuous irrigation Vacuum sealing drainage Open wounds |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 徐卫国,王晓卫,万春友,刘磊,全先辉,杨光,朱旭伟.负压封闭引流结合灌洗技术在骨科开放性创面治疗中的应用[J].中国骨伤,2016,29(4):325~328 |
| 英文格式: | XU Wei-guo,WANG Xiao-wei,WAN Chun-you,LIU Lei,QUAN Xian-hui,YANG Guang,ZHU Xu-we.Clinical application of vacuum sealing drainage combined with closed continuous irrigation in treatment of the orthopaedic open wounds[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):325~328 |
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