负压封闭引流技术修复皮肤软组织缺损难愈性创面的应用效果(1)
[摘要]目的：探讨负压封闭引流术(Vacuum sealing drainage，VSD)治疗软组织缺损难愈性创面的临床效果，为临床软组织缺损难愈性创面治疗方案选择提供参考。方法：选择2016年1月-2018年1月笔者医院收治的软组织缺损难愈性创面患者86例作为研究对象，按照入组顺序编号，采用随机数字表法分为对照组和观察组，每组43例。对照组采用传统换药法治疗，观察组采用VSD治疗。比较两组患者治疗次数、每次治疗时数字疼痛评分(Numerical rating scale，NRS)、完成治疗后的创面愈合率、创面愈合时间、并发症发生率及植皮医生对创面外观满意度。结果：观察组治疗次数、疼痛评分、创面愈合时间均明显低于对照组，创面愈合率及愈合外观满意度高于对照组，差异有统计学意义(P<0.05)。观察组并发症发生率高于对照组，但差异无统计学意义(P>0.05)。结论：VSD治疗软组织缺损难愈性创面愈合效果、愈合外观优于传统换药治疗法，且具有耗时短、患者疼痛程度低的优势，可为后续植皮治疗提供良好创基条件，具有较高的临床价值。
[关键词]难愈性创面；软组织缺损；负压封闭引流术；创面愈合；临床效果
, 百拇医药
[中图分类号]R622 [文献标志码]B [文章编号]1008-6455(2018)07-0046-03
Abstract： Objective To analyze the effect of vacuum sealing drainage (VSD) in the treatment of wound healing of soft tissue defects， and to provide reference for the treatment of soft tissue defects. Methods 86 patients with soft tissue defects which were treated in our hospital from January 2016 to January 2018 were selected as the subjects. And they were numbered accorded to the sequence of entried group， the patients were randomly divided into the control group and the observation group by the digital random table， 43 cases in each group. The control group was treated with traditional dressing method， while the observation group was treated with VSD. The number of treatment， the numerical rating scale score， the healing rate after the treatment， the healing time of the wound， the satisfaction of the subsequent skin grafting doctors on the appearance of the wound and the incidence of complications were compared between the two groups. Results The number of treatment， the numerical rating scale score and the wound healing time in the observation group were significantly lower than those in the control group， and the wound healing rate and the satisfaction of the healing appearance were higher than those of the control group， the differences were statistically significant(P<0.05). The incidence of complications in the observation group was higher than that in the control group， but the difference was not statistically significant(P>0.05). Conclusion The healing rate and appearance of VSD in the treatment of soft tissue defect are better than traditional dressing therapy. It has the advantages of short time and low pain. It provides good conditions for subsequent skin grafting treatment， and has high clinical value.
, 百拇医药
Key words： refractory wound； soft tissue defect； vacuum sealing drainage； wound healing； clinical effect
皮膚软组织损伤是外科常见病，可以由外伤导致，也可以是其它外科疾病的伴发疾病[1-2]。伴发软组织缺损的患者在治疗过程中，往往难以通过一次治疗闭合伤口，损伤处并发感染的几率高，伤口愈合时间长，从而形成软组织缺损难愈性创面。此类创面治疗难度大，传统的治疗方法以反复换药促进肉芽组织增生为后续植皮治疗提供新生组织基础[3]。合格的创面前处理是后续植皮治疗的基础。传统换药法时间长、医护人员工作量大，且并发感染后增加了原发疾病的治疗难度，给患者的生命安全带来较大隐患[4-6]。负压封闭引流术(Vacuum sealing drainage，VSD)是近年来临床应用较为广泛的创面修复治疗方法。其通过负压彻底吸引腐烂组织、脓液，去除病原菌滋生的基础，促进新生组织生长。部分软组织缺损难愈创面通过VSD治疗即可获得有效愈合，而不需要进行植皮或者其它创面修复技术治疗[7-8]。本研究对VSD治疗软组织缺损难愈性创面和传统换药法治疗进行对比分析，了解两种治疗方法的临床疗效、安全性优劣，为临床此类患者的治疗方案选择提供参考。现报道如下。, 百拇医药(周雪莲)
[关键词]难愈性创面；软组织缺损；负压封闭引流术；创面愈合；临床效果
, 百拇医药
[中图分类号]R622 [文献标志码]B [文章编号]1008-6455(2018)07-0046-03
Abstract： Objective To analyze the effect of vacuum sealing drainage (VSD) in the treatment of wound healing of soft tissue defects， and to provide reference for the treatment of soft tissue defects. Methods 86 patients with soft tissue defects which were treated in our hospital from January 2016 to January 2018 were selected as the subjects. And they were numbered accorded to the sequence of entried group， the patients were randomly divided into the control group and the observation group by the digital random table， 43 cases in each group. The control group was treated with traditional dressing method， while the observation group was treated with VSD. The number of treatment， the numerical rating scale score， the healing rate after the treatment， the healing time of the wound， the satisfaction of the subsequent skin grafting doctors on the appearance of the wound and the incidence of complications were compared between the two groups. Results The number of treatment， the numerical rating scale score and the wound healing time in the observation group were significantly lower than those in the control group， and the wound healing rate and the satisfaction of the healing appearance were higher than those of the control group， the differences were statistically significant(P<0.05). The incidence of complications in the observation group was higher than that in the control group， but the difference was not statistically significant(P>0.05). Conclusion The healing rate and appearance of VSD in the treatment of soft tissue defect are better than traditional dressing therapy. It has the advantages of short time and low pain. It provides good conditions for subsequent skin grafting treatment， and has high clinical value.
, 百拇医药
Key words： refractory wound； soft tissue defect； vacuum sealing drainage； wound healing； clinical effect
皮膚软组织损伤是外科常见病，可以由外伤导致，也可以是其它外科疾病的伴发疾病[1-2]。伴发软组织缺损的患者在治疗过程中，往往难以通过一次治疗闭合伤口，损伤处并发感染的几率高，伤口愈合时间长，从而形成软组织缺损难愈性创面。此类创面治疗难度大，传统的治疗方法以反复换药促进肉芽组织增生为后续植皮治疗提供新生组织基础[3]。合格的创面前处理是后续植皮治疗的基础。传统换药法时间长、医护人员工作量大，且并发感染后增加了原发疾病的治疗难度，给患者的生命安全带来较大隐患[4-6]。负压封闭引流术(Vacuum sealing drainage，VSD)是近年来临床应用较为广泛的创面修复治疗方法。其通过负压彻底吸引腐烂组织、脓液，去除病原菌滋生的基础，促进新生组织生长。部分软组织缺损难愈创面通过VSD治疗即可获得有效愈合，而不需要进行植皮或者其它创面修复技术治疗[7-8]。本研究对VSD治疗软组织缺损难愈性创面和传统换药法治疗进行对比分析，了解两种治疗方法的临床疗效、安全性优劣，为临床此类患者的治疗方案选择提供参考。现报道如下。, 百拇医药(周雪莲)