封闭负压引流技术在开放骨折合并软组织缺损治疗中的作用

目的探讨封闭负压引流技术(VSD)在治疗开放骨折合并软组织缺损中的作用。方法应用VSD及内固定或外固定支架结合植皮或邻近皮瓣治疗25例开放骨折合并软组织缺损患者。结果患者均获随访,时间4~18个月。16例患者VSD术后5~7 d解除负压,经植皮治疗后创面均愈合;7例较严重开放骨折合并软组织缺损患者经2次VSD治疗后,给予植皮+邻近皮瓣转移覆盖创面后创面均愈合;2例严重开放骨折合并软组织缺损患者经3次VSD治疗后,行植皮+邻近皮瓣转移覆盖创面治疗后均获得愈合。结论 VSD能刺激肉芽组织生长,控制创面炎症,只需结合简单易行的植皮或邻近皮瓣应用即可理想地修复组织缺损创面。

Vacuum sealing drainage technique in the treatment of open fracture with soft tissue defect

Objective To study the clinical effect of vacuum sealing drainage （ VSD） in the treatment of open frac-tures with soft tissue defect. Methods 25 patients with open fractures and soft tissue defects were treated by VSD and internal fixation or external fixation, adjacent flap or skin grafting. Results All patients were followed up for 4-18 months. 16 patients were treated by VSD for 5-7 days, and then through skin grafting treatment, the wound were healed. 7 cases of more severe open fracture with soft tissue defects in patients with VSD treatment by 2 times, which were given skin grafting and adjacent flap to cover the wound, the wound were healed. 2 cases of the most severe open fracture with soft tissue defects in patients with VSD treatment by 3 times, giving skin grafting and adjacent flap to cover the wound, the wound were healed. Conclusions VSD can stimulate the growth of granulation tissue, control wound inflammation. Only with simple skin grafting or adjacent flap,VSD can repair most refractory tissue defect satis-factorily.