摘要
目的探讨应用负压封闭引流（VSD）辅助治疗腹部术后切口感染的效果。方法2006年8月-2009年12月间，28例腹部术后发生切口感染、裂开的患者接受VSD治疗，清创后将Vacuseal材料覆盖在相应大小的创面表面或创腔内，接-50--60kPa的中心负压，7～9d后二期缝合、植皮。与同期20例未使用负压封闭技术的20例腹部切口感染者进行对比。结果28例患者中采用二期缝合后甲级愈合25例，中厚皮植皮关闭2例，1例吸毒、结肠脾曲损伤漏诊患者死于腹腔严重感染。与传统换药方法比较，在二期缝合、植皮的时间、换药次数、住院时间和总体治疗费用等方面均有显著性差异（P〈0．01）。结论应用VSD能够清除切口创面的污染，充分引流和刺激创面肉芽组织快速良好生长，缩短治疗时间。对于严重腹部创伤术后发生切口并发症的患者具有简单安全、经济有效，并易于接受的优点。
Objective To investigate the clinical effect of vacuum assisted closure in treating abdominal incision complication. Methods From August 2006 to December 2009, 28 patients with abdominal incision complication were treated by vacuum sealing after debridement. The wound area ranged from 3 cm - 5 cm to 20 cm - 40 cm. In the treated group, the wound surfaces or cavities were filled with polyvinyl alcohol foams with embedded drainage tubes connected with vacuum bottle （negative pressure of 50-60 kPa）. Definite wound closure was performed with secondary suture, or skin grafting after 7-9 days. Besides, 20 patients were managed by traditional dressing as the control group from January 1998 to July 2001. Results Of 28 patients, the wound closure was performed with sequential secondary suture in 25, split thickness skin grafts （STSG） in 2 ,one patient with injury of splenic flexure of colon and drug abuse died of serious abdominal in- fection. All patients recovered and no complication （systemic and located） occurred. There were significant differences in time of secondary closure, times of dressing and total cost of treatment between two groups （P 〈 0. 01 ）. Conclusions VSD therapy can protect the wound from contamination; evacuate the wound exu- dates completely, stimulate the growth of granulation tissue, and facilitate the wound healing; So VSD therapy is a simple and effective method for abdominal incision complication.
出处
《国际外科学杂志》
2010年第4期235-237,共3页
International Journal of Surgery
关键词
腹部
负压封闭引流
感染
并发症
Abdomen
Vacuum sealing drainage
Infection
Complication
