【摘要】 目的观察负压吸引技术(VSD)持续负压灌洗、引流对高压电损伤创面修复的影响。方法将56个上肢受伤部位患者(35例高压电损伤患者)按不同的治疗方法分为2组:试验组和对照组,每组28个部位。对照组患者采用全身及局部治疗;试验组在对照组全身和局部治疗的基础上采用VSD持续负压灌洗、引流1～3周,7d更换1次新的VSD敷料,术后1～3周拆除负压吸引装置。观察2组患者创面肉芽生长情况,再根据创面情况选择皮片或皮瓣封闭创面。结果试验组在清创治疗后,后期覆盖创面,其中植皮为14个部位,腹部带蒂皮瓣为14个部位;对照组在清创治疗后,后期覆盖创面,其中植皮为14个部位,腹部带蒂皮瓣为14个部位。试验组创面肉芽生长快,皮片或皮瓣覆盖后愈合快;对照组创面肉芽生长相对较慢。试验组皮片、皮瓣成活率均为100.0%,均明显高于对照组的85.7%、92.9%(均P<0.05),试验组皮片、皮瓣移植患者的住院时间分别为(42.5±2.2)、(58.3±4.3)d,均明显低于对照组的(49.4±2.1)、(62.3±4.2)d(均P<0.05)。结论 VSD持续负压灌洗、引流能明显地改善高压电损伤肉芽生长创面情况,为进一步封闭创面提供了良好的条件,提高了皮片或皮瓣修复创面的成功率,明显缩短了住院时间。更多还原

【Abstract】 Objective To observe the effects of vacuum sealing drainage(VSD) with continuous negative pressure lavation and drainage on wound repair in high voltage electrical injury.Methods Fifty-six upper limb injury sites(35 patients with high voltage electrical injuries) were divided into experiment group and control group,with 28 sites in each group.All patients were treated with whole-body and local treatment.Additionally,experiment group was given VSD with continuous negative pressure lavation and drainage for 1-3 weeks and the VSD dressing was replaced every 7 days.The growth of granulation tissue was observed,and then skin grafts or flaps were chosen to close the wound surface.Results After debridement,skin grafts were used in 14 sites and abdominal pedicle flaps in 14 sites in experiment group,as well as in control group.Granulation tissue grew and wounds healed rapidly in experiment group,but slowly in control group.Compared with control group,VSD significantly increased survival rates of skin grafts and flaps(100.0% and 100.0% vs 85.7% and 92.9%,respectively,P<0.05),and obviously decreased hospital stay in patients with skin grafts and patients with abdominal pedicle flaps[(42.5±2.2) and(58.3±4.3)days vs(49.4±2.1) and(62.3±4.2)days,respectively,P<0.05)].Conclusion The application of VSD with continuous negative pressure lavation and drainage can improve the growth situation of granulation tissue to provide a good condition for further closing wound surface,increase the success rates of wound surface repair with skin grafts or flaps,and shorten the hospital stay in high voltage electrical injury.更多还原