摘要
目的探讨封闭式负压吸引技术结合腓肠神经逆行皮瓣在小腿中下段GustiloⅢA、B型开放性骨折中的治疗作用,方法对21例小腿中下段GustiloⅢA、B型开放性骨折的患者,经清创后采用单次或多次封闭式持续负压吸引7～28d(平均10.3d),待创面条件改善后二期行腓肠神经逆行皮瓣转移覆盖剩余创面.结果21例清创前细菌培养阳性,经封闭式负压吸引技术治疗.肉芽组织丰富、新鲜和出血活跃,渗出液细菌培养阴性,二期行腓肠神经逆行皮瓣覆盖创面后,创面均痊愈,无1例发生创面深部感染或创伤性骨髓炎.结论通过封闭负压吸引技术结合腓肠神经逆行皮瓣移植治疗小腿中下段GustiloⅢA、B型骨折,可以简便、有效的提高腓肠神经逆行皮瓣移植的手术效果,缩短患者的病程及住院时间。
Objective To explore the experiences of treating Gustilo grade Ⅲ AZB fractures in legs with reverse sural neurocutaneous flap and Vacuum - sealing drainage technique （ VSD ）. Methods Twenty - one Gustilo grade ⅢA/B fractures in the middle and distal leg fractures were debrided and Vacuum - sealing drained for 7 -28 days （average 10. 3 days）, and then transplanted with the reverse sural neurocutaneous flap when the wound condition was improved. Results The bacterial cultures before debridement were positive in all cases. After undergoing VSD, the wounds were covered with fresh and productive granulation tissues. When negative resuits of bacterial cultures were obtained, reverse sural neurocutaneous flaps were transplanted to repair soft tissue defects. All cases were healing, while no deep tissue infection and traumatic osteomyelitis occurred. Conclusions By using the reverse sural neurocutaneous flap combined VSD technique to treat Gustilo grade ⅢA/B fractures in legs, improved therapeutic effects were gained, and the duration of hospitalization was shortened as well.
出处
《昆明医学院学报》
2007年第5期52-55,共4页
Journal of Kunming Medical College
关键词
开放性骨折
小腿
封闭负压吸引
腓肠神经逆行皮瓣
Open fracture
Leg
Vacuum -sealing drainage
Reverse sural neurocutaneous flap
