持续负压封闭引流术在急、慢性创面修复中的临床应用分析

发布时间：2018-04-24 08:31

本文选题：持续封闭负压引流技术（vacuum + sealing　；参考：《皖南医学院》2013年硕士论文

【摘要】：目的：通过观察持续封闭负压引流技术（vacuum sealing drainage，VSD）在急、慢性创面修复中的临床应用，评价其临床疗效及安全性。方法：总结皖南医学院附属弋矶山医院烧伤整形科2012年01月至2012年12月经持续封闭负压引流技术治疗的各种原因所致急、慢性创面患者，共60例，其中男39例，女21例，年龄5-90岁。急性创面40例，慢性创面20例。所有患者均予常规治疗，，高血压、糖尿病患者予以控制血压、血糖治疗。观察并记录患者应用VSD治疗前、后创面各方面改变，包括创面坏死组织清除、创面细菌清除、创面肉芽组织生长、是否出现创面出血、过敏等并发症，以及应用VSD治疗过程中患者疼痛程度，VSD治疗后创面愈合情况及患者满意度。患者创面愈后、功能恢复及满意度通过定期复查和电话回访以问卷调查的方式收集资料，进行统计分析。结果：本组60例急、慢性创面患者经持续封闭负压引流技术治疗6-20天后，创面坏死组织完全清除，肉芽组织生长新鲜，达手术修复条件的患者有88%。在使用VSD治疗的过程中，60例患者中有43例没有疼痛或轻微疼痛感，仅5例患者不能忍受疼痛，部分患者出现创周皮肤浸渍现象，4例患者出现过敏现象，4例患者出现创面渗血，1例患者创面加重。应用负压吸引对创面细菌有效清除率达80%，创面细菌培养阳性率明显降低，创面治愈率达100%。愈后随访1-12个月，所有患者关节功能渐恢复正常，创面均愈合良好，未出现创面感染、复发、并发慢性骨髓炎症状。植皮创面疤痕增生不明显，颜色接近正常皮肤，质地及耐磨性良好，未见移植皮肤磨损破溃，皮瓣臃肿度渐消，受瓣区及供瓣区创面感觉功能逐渐恢复；患者及家属满意度90%。结论：持续封闭负压引流技术具有控制创面感染、抑制细菌生长，清除坏死组织、刺激创面肉芽组织生长，减轻患者痛苦及缩短治疗时间等优点，是治疗急、慢性创面的一种简单、有效的方法。
[Abstract]:Objective: to evaluate the clinical efficacy and safety of vacuum sealing drainage drainage (VSD) in the repair of acute and chronic wounds. Methods: from January 2012 to December 2012, the Department of Burn and plastic surgery, affiliated to Southern Anhui Medical College, summarized 60 patients with chronic wounds, including 39 males and 21 females, from January 2012 to December 2012. Age 5-90 years. Acute wound in 40 cases, chronic wound in 20 cases. All patients were given routine treatment, hypertension, diabetes to control blood pressure, blood sugar treatment. The changes of wound surface before and after VSD treatment were observed and recorded, including wound necrosis tissue clearance, wound bacterial clearance, granulation tissue growth, wound bleeding, hypersensitivity and other complications. And the wound healing and patient satisfaction after VSD treatment. After the wound healing, the patients' functional recovery and satisfaction were collected and analyzed by means of regular reexamination and telephone interview. Results: 60 patients with acute and chronic wounds were treated with continuous negative pressure drainage for 6-20 days. The necrotic tissue was completely cleared, granulation tissue grew fresh, and 88 patients reached the condition of operation and repair. In the course of VSD treatment, 43 out of 60 patients had no pain or mild pain, and only 5 patients could not endure pain. There were 4 cases of hypersensitivity in 4 patients and 1 case of aggravated wound surface. The effective clearance rate of bacteria in wound was 80% by suction of negative pressure, the positive rate of bacterial culture in wound was obviously decreased, and the cure rate of wound was 100%. All the patients were followed up for 1 to 12 months. The joint function of all the patients gradually returned to normal. The wound healed well without infection and recurrence of the wound and complicated with chronic osteomyelitis. The scar hyperplasia was not obvious, the color was close to normal skin, the texture and abrasion resistance was good, there was no skin graft wear and tear, the skin flap bloated gradually, the sensory function of the flap and donor flap gradually recovered, and the satisfaction of the patients and their families was 90%. Conclusion: continuous negative pressure drainage has the advantages of controlling wound infection, inhibiting bacterial growth, removing necrotic tissue, stimulating the growth of granulation tissue, alleviating the pain of patients and shortening the time of treatment. A simple and effective method for chronic wounds.
【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R641

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