The clinical effect of VSD technology in the treatment of high perianal abscess_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

REN Long ,  XIE Yixiang , WANG Chuansi , YAO Lei , HUANG Hongwu , WANG Yongsen , WU Yongjun

Department of Anorectal Surgery, The Affiliated Lu'an Hospital of Anhui Medical University, Lu'an, Anhui 237005, P.R.China;

Corresponding author：

XIE Yixiang, Email: xieyx888@126.com

Keywords：

high perianal abscess; vacuum sealing drainage; closure of internal orifice; low incision combined with high thread operation

DOI：

10.7507/1007-9424.201608110

Video：

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Objective To evaluate the clinical effect of vacuum sealing drainage (VSD) technology in the treatment of high perianal abscess. Methods A total of 38 cases of high perianal abscess who underwent surgery in our hospital from May. 2014 to Feb. 2016 were randomly divided into 2 groups: the VSD group (n=19) and the control group (n=19). The cases of VSD group were performed with closure of internal orifice+VSD technique, and the cases of control group were treated with radical operation of perianal abscess (low incision combined with high thread operation). The following indexes of cases in 2 groups were compared and analyzed, including postoperative pain score, wound healing time, postoperative anal function score, and prognosis. Results There were significant differences in pain score (3.53±0.70vs. 5.11±0.74), postoperative anal function score (0vs. 1), and wound healing time〔(27.58±4.95) dvs. (44.68±6.53) d〕between VSD group and control group,P<0.05. Compared with the control group, the pain score and anal function score of the VSD group were both lower, and the wound healing time was shorter. However, there was no statistically significant difference in incidence of fistula between the two groups〔5.3% (1/19)vs. 15.8% (3/19),P=0.60〕. Conclusion In the treatment of high perianal abscess, VSD technology can relieve pain in patients, shorten the wound healing time, protect the anal function, and the prognosis is as well as low incision combined with high thread operation, so VSD is a better treatment method for high perianal abscess.

Citation： REN Long, XIE Yixiang, WANG Chuansi, YAO Lei, HUANG Hongwu, WANG Yongsen, WU Yongjun. The clinical effect of VSD technology in the treatment of high perianal abscess. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(3): 282-285. doi: 10.7507/1007-9424.201608110 Copy

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2.	王传思, 谢贻祥. 半胶管引流Ⅰ期根治多间隙肛周脓肿的临床研究. 结直肠肛门外科, 2011, 17(5): 328-330.
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11.	郭茂华, 袁月姣, 周锦都, 等. 高压氧在重度肛周脓肿术后消炎促愈作用. 结直肠肛门外科, 2010, 16(3): 162-163.
12.	文家勇, 万萍. 贝复济在肛周脓肿术后换药中的临床疗效观察. 西藏医药杂志, 2005, 26(2): 27-28.
13.	纪凤兰, 张建华. 银离子敷料用于肛周脓肿切开术后的临床效果观察. 中国医药导报, 2010, 7(27): 34-35.
14.	赵永娇, 何颖华, 智建文, 等. 中医祛腐生肌法换药促进肛周脓肿、肛瘘术后患者创面愈合的临床观察. 北京中医药, 2011, 30(3): 203-204.
15.	Fleischmann W, Becker U, Bischoff M,et al. Vacuum sealing: indication, technique, and results. Eur J Orthop Surg Traumatol, 1995, 5(1): 37-40.
16.	Chen SZ, Li J, Li XY,et al. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg, 2005, 28(3): 211-217.
17.	许龙顺, 陈绍宗, 乔骋, 等. 负压对创面血流量的影响. 第四军医大学报, 2000, 21(8): 976-978.
18.	李靖, 陈绍宗, 李学拥, 等. 封闭负压引流对创面微循环超微结构影响的实验研究. 中国美容整形外科杂志, 2006, 17(1): 75-77.
19.	胡祥, 喻爱喜, 俞国荣, 等. 负压封闭引流对创面细胞黏附分子-1 表达及 IkBα 磷酸化的影响. 中华实验外科杂志, 2012, 29(1): 123-125.
20.	吕小星, 陈绍宗, 李学拥, 等. 封闭负压引流技术对创周组织水肿及血管通透性的影响. 中国临床康复, 2003, 7(8): 1244-1245.
21.	Squier CA. The effect of stretching on formation of myofibroblasts in mouse skin. Cell Tissue Res, 1981, 220(2): 325-335.
22.	Takei T, Mills I, Arai K,et al. Molecular basis for tissue expansion: clinical implications for the surgeon. Plast Reconstr Surg, 1998, 102(1): 247-258.
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25.	Thompson G. An overview of negative pressure wound therapy (NPWT). Br J Community Nurs, 2008, 13(6): S23-S24, S26, S28-S30.
26.	王声政, 魏金星, 张雪培, 等. 负压封闭引流技术在 Fournier 坏疽中的应用. 中华外科杂志, 2013, 51(11): 1044-1045.
27.	Murthi GV, Okoye BO, Spicer RD,et al. Perianal abscess in childhood. Pediatr Surg Int, 2002, 18(8): 689-691.
28.	方征宇, 潘志芸, 李乾元, 等. VSD 在肛周脓肿术后创面应用的临床观察. 浙江临床医学, 2016, 18(6): 1071-1072.
29.	杨帆, 白祥军. 负压封闭引流 (VSD) 技术在各类创面的应用研究进展. 创伤外科杂志, 2011, 13(1): 82-84.

1. 胡伯虎. 大肠肛门病治疗学. 北京: 科学技术文献出版社, 2004: 300-301.
2. 王传思, 谢贻祥. 半胶管引流Ⅰ期根治多间隙肛周脓肿的临床研究. 结直肠肛门外科, 2011, 17(5): 328-330.
3. 王传思, 谢贻祥. 熏洗Ⅰ号方治疗肛周脓肿术后疗效观察. 四川中医, 2011, 29(12): 91-92.
4. 国家中医药管理局. 中医病证诊断疗效标准. 南京: 南京大学出版社, 1994: 132-133.
5. 蒋琪霞, 刘云, 徐薇, 等. 负压伤口治疗关键技术的研究进展. 医学研究生学报, 2007, 20(6): 656-659.
6. 陈雷. 肛周脓肿一次性根治术 120 例临床分析. 吉林医学, 2010, 31(22): 3744-3745.
7. Senn S. Analysis of serial measurements in medical research. BMJ, 1990, 300(6725): 680.
8. Modlin IM. Surgical triumvirate of Theodor Kocher, Harvey Cushing, and William Halsted. World J Surg, 1998, 22(1): 103-113.
9. 余洪艳, 韦俊武. 一期根治术治疗小儿肛周脓肿 56 例临床分析. 结直肠肛门外科, 2012, 18(6): 368-369.
10. 王岩, 李树杰, 王军, 等. 肛周脓肿一期手术治疗临床疗效观察(附 107 例报道). 中国普外基础与临床杂志, 2009, 16(9): 755-756.
11. 郭茂华, 袁月姣, 周锦都, 等. 高压氧在重度肛周脓肿术后消炎促愈作用. 结直肠肛门外科, 2010, 16(3): 162-163.
12. 文家勇, 万萍. 贝复济在肛周脓肿术后换药中的临床疗效观察. 西藏医药杂志, 2005, 26(2): 27-28.
13. 纪凤兰, 张建华. 银离子敷料用于肛周脓肿切开术后的临床效果观察. 中国医药导报, 2010, 7(27): 34-35.
14. 赵永娇, 何颖华, 智建文, 等. 中医祛腐生肌法换药促进肛周脓肿、肛瘘术后患者创面愈合的临床观察. 北京中医药, 2011, 30(3): 203-204.
15. Fleischmann W, Becker U, Bischoff M,et al. Vacuum sealing: indication, technique, and results. Eur J Orthop Surg Traumatol, 1995, 5(1): 37-40.
16. Chen SZ, Li J, Li XY,et al. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg, 2005, 28(3): 211-217.
17. 许龙顺, 陈绍宗, 乔骋, 等. 负压对创面血流量的影响. 第四军医大学报, 2000, 21(8): 976-978.
18. 李靖, 陈绍宗, 李学拥, 等. 封闭负压引流对创面微循环超微结构影响的实验研究. 中国美容整形外科杂志, 2006, 17(1): 75-77.
19. 胡祥, 喻爱喜, 俞国荣, 等. 负压封闭引流对创面细胞黏附分子-1 表达及 IkBα 磷酸化的影响. 中华实验外科杂志, 2012, 29(1): 123-125.
20. 吕小星, 陈绍宗, 李学拥, 等. 封闭负压引流技术对创周组织水肿及血管通透性的影响. 中国临床康复, 2003, 7(8): 1244-1245.
21. Squier CA. The effect of stretching on formation of myofibroblasts in mouse skin. Cell Tissue Res, 1981, 220(2): 325-335.
22. Takei T, Mills I, Arai K,et al. Molecular basis for tissue expansion: clinical implications for the surgeon. Plast Reconstr Surg, 1998, 102(1): 247-258.
23. Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Ann Plast Surg, 2004, 52(3): 276-280.
24. Polykandriotis E, Kneser U, Kopp J,et al. Modified gloving technique for vacuum therapy in the hand. Zentrabl Chir, 2006, 131 Suppl 1: S36-S39.
25. Thompson G. An overview of negative pressure wound therapy (NPWT). Br J Community Nurs, 2008, 13(6): S23-S24, S26, S28-S30.
26. 王声政, 魏金星, 张雪培, 等. 负压封闭引流技术在 Fournier 坏疽中的应用. 中华外科杂志, 2013, 51(11): 1044-1045.
27. Murthi GV, Okoye BO, Spicer RD,et al. Perianal abscess in childhood. Pediatr Surg Int, 2002, 18(8): 689-691.
28. 方征宇, 潘志芸, 李乾元, 等. VSD 在肛周脓肿术后创面应用的临床观察. 浙江临床医学, 2016, 18(6): 1071-1072.
29. 杨帆, 白祥军. 负压封闭引流 (VSD) 技术在各类创面的应用研究进展. 创伤外科杂志, 2011, 13(1): 82-84.

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The clinical effect of VSD technology in the treatment of high perianal abscess

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