【摘要】 目的:探讨封闭式负压引流技术(Vacuum sealing drainage,VSD)治疗儿童感染创面的临床疗效。方法:2008年7月-2010年3月,收治15例感染创面患儿,其中地震伤3例,交通事故伤10例,重物压砸伤2例。均为下肢损伤共15例共35处创面。创面皮肤软组织均有不同程度坏死,伴肌腱外露11例,骨外露7例,骨筋膜室综合征2例,骨折内固定10例。彻底清创后,采用VSD材料覆盖创面,维持压力于0.04 MPa,持续引流7~10 d。结果:除1例未完成VSD治疗外,其余患儿经治疗后创面均明显缩小,肉芽组织生长良好,采用皮片(13例)或皮瓣(1例)游离移植修复创面,皮片及皮瓣均一期愈合,皮片及皮瓣外形、质地、颜色等传统方法比较无差异。结论:VSD治疗儿童感染创面时创面肉芽培养在10~20 d左右,而传统方法等待创面坏死皮肤自溶脱落及更换敷料培养肉芽常需1~2月时间,故能明显缩短病程,减轻患儿痛苦及家属心理负担,有效控制创面感染,促进肉芽组织生长,从而取得显著的治疗效果。更多还原

【Abstract】 Objective:To investigate the curative effect of vacuum sealing drainage(VSD)in children with infected wounds.Methods:From July 2008 to March 2010,15 children with infected wounds were treated,including earthquake damage in 3 cases,traffic accident in 10 cases,and heavy crush injury in 2 cases.All the 15 patients with injuries had 35 wounds in the lower limbs;the wounds had varying degrees of skin and soft tissue necrosis,with 11 cases of tendon exposure,7 cases of bone exposure,2 cases with bone compartment syndrome,and 10 cases of fracture fixation.After the debridement,the VSD material covered the wound to maintain the pressure at the 0.04 MPa,and kept continuous drainage 7~10 d.Results:Except for one child who gave up,all the wounds were narrowed obviously;granulation tissue grew well.In wound repair using skin grafts(13 patients)or flap(1 patient)graft,skin graft and flap graft were the first stage healing.The shape,texture,and color showed no difference compared with other traditional methods.Conclusion:For the VSD treatment of children with infected wounds,the culture of granulation tissue needs about 10 days to 20 days,while the traditional method needs about 1 to 2 months before the autolysis and necrotic skin off and replacement of the dressing.Therefore,the VSD treatment can significantly shorten the course,reduce the psychological burden of children and economic burden of their families,effectively control the wound infection,promote the growth of granulation tissue,and thus obtain a significant therapeutic effect.更多还原