真空负压引流技术联合人工真皮治疗糖尿病足的效果

发布时间：2018-05-29 17:44

本文选题：糖尿病足 + 清创术　；参考：《广东医学》2016年14期

【摘要】：目的观察真空负压引流(VSD)技术联合人工真皮治疗糖尿病足的临床疗效。方法 24例糖尿病足患者平均分成两组,全部患足仍有较大部分皮肤软组织存在血运,予抗炎及控制血糖平稳后,所有患足均行坏死组织清创术并形成新鲜创面。对照组12例:清创术后予传统方法换药治疗,每天双氧水、生理盐水清洗,聚维酮碘纱布外敷包扎。观察组12例:清创术后应用VSD技术治疗创面,创面感染控制、肉芽组织生长后植入人工真皮,待其肉芽生长满意后行植皮术。观察患者住院时间及愈合质量,包括截肢率及瘢痕增生情况等。结果对照组住院时间(52.2±6.7)d,其中截肢患者5例,创面瘢痕愈合患者3例,最后经植皮修复者4例。观察组住院时间(30.5±5.9)d,其中3例创面较小患者经应用VSD技术联合人工真皮后创面瘢痕愈合,瘢痕增生轻;8例创面较大患者应用VSD技术联合人工真皮后肉芽生长既快又好,肉芽满意后行植皮手术,植皮全部存活,保肢成功;1例较严重患者最终截肢处理。结论 VSD技术联合人工真皮治疗糖尿病足效果明显优于传统治疗方法,可降低截肢率,缩短住院时间。
[Abstract]:Objective to observe the clinical effect of vacuum negative pressure drainage (VSD) combined with artificial dermis in the treatment of diabetic foot. Methods 24 patients with diabetic foot were divided into two groups. There was still a large part of skin and soft tissue blood circulation in all affected feet. After anti-inflammatory and blood glucose control, all the affected feet underwent debridement of necrotic tissue and formed fresh wound. Control group (12 cases): after debridement, traditional methods were used to change medicine, hydrogen peroxide and saline were cleaned daily, and povidone iodine gauze was bandaged externally. In the observation group, 12 cases were treated with VSD technique after debridement, wound infection was controlled, granulation tissue was implanted into artificial dermis after debridement, and skin grafting was performed after satisfactory granulation growth. The hospitalization time and healing quality were observed, including amputation rate and scar proliferation. Results in the control group, the hospital stay was 52.2 卤6.7 days, including 5 amputations, 3 scar healing and 4 skin graft repair. In the observation group, the duration of hospitalization was 30.5 卤5.9 days. Three patients with small wounds were treated with VSD technique combined with artificial dermis, and 8 patients with light scar hyperplasia were treated with VSD technique and artificial dermis. The granulation growth was fast and good after the application of VSD technique and artificial dermis. After the granulation was satisfied, the skin grafts survived, and one serious patient was treated with amputation. Conclusion the effect of VSD combined with artificial dermis on diabetic foot is better than that of traditional treatment, which can reduce amputation rate and shorten hospitalization time.
【作者单位】：广东省茂名市人民医院手足显微外科;
【基金】：广东省茂名市第二批(医疗卫生类)科技计划项目(编号:2015013)
【分类号】：R587.2

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