west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "封闭式负压引流" 43 results
  • 双下肢离断毁损伤前足移位再植一例五年随访报告

    目的报告1例采用离断的右足移位再植修复毁损左足的临床效果。 方法2007年5月收治1 例火车碾压致右踝及左前足离断的患者,伤后8 h入院。急诊手术将右小腿截肢,右足移位再植于左足。采用封闭式负压引流技术治疗未闭合创面,二期行游离植皮术。术后6个月右下肢安装义肢。 结果患者移位再植的左前足成活,植皮区成活。术后5年随访,生活已同常人,可完全自理;左足第4、5趾感觉良好,两点辨别觉约10 mm,第1、2、3趾感觉较差;踝关节活动度正常;按Sanders等提出的Maryland足功能评分标准评分为94分,达优。 结论双下肢离断毁损伤移位再植术可保全患者一侧肢体,并能获得良好功能。

    Release date:2016-08-31 04:05 Export PDF Favorites Scan
  • 封闭式负压引流技术联合腓肠神经营养血管皮瓣修复儿童足跟部软组织缺损

    目的总结封闭式负压引流技术(vacuum sealing drainage,VSD)联合腓肠神经营养血管皮瓣修复儿童足跟部软组织缺损的疗效。 方法2010年1月-2012年6月,收治7例足跟部软组织缺损患儿。男5例,女2例;年龄5岁11个月~11岁1个月,平均8岁1个月。致伤原因:重物砸伤2例,车轮绞伤4例,机械皮带绞伤1例。受伤至入院时间3~5 h,平均4 h。软组织缺损范围为5 cm × 3 cm~8 cm × 6 cm。入院急诊清创、VSD治疗5~7 d后,切取大小为6 cm × 4 cm~9 cm × 7 cm的腓肠神经营养血管皮瓣修复创面。供区游离植皮、皮瓣修复或直接拉拢缝合。 结果术后皮瓣均顺利成活,创面Ⅰ期愈合;供区皮瓣及植皮均成活,切口Ⅰ期愈合。患儿均获随访,随访时间6~15个月,平均9个月。皮瓣质地优良,外观无臃肿,耐磨。术后6个月足踝部功能采用美国矫形足踝协会(AOFAS)后足评分系统进行评价,均为优。 结论VSD联合腓肠神经营养血管皮瓣修复儿童足跟部组织缺损简便安全,降低了感染率,可有效判断周围皮肤条件,减少皮瓣切取面积,且皮瓣血运可靠。

    Release date:2016-08-31 04:07 Export PDF Favorites Scan
  • 封闭式负压引流与人工真皮联合应用治疗下肢慢性溃疡

    目的 总结联合应用封闭式负压引流与人工真皮治疗下肢慢性溃疡的临床效果。 方法 2011年1 月-2012年6月,收治19例下肢慢性溃疡患者。其中男10例,女9例;年龄12~68岁,平均46岁。病因:创伤性溃疡7例,静脉淤血性溃疡3例,动脉供血不足性溃疡1例,神经营养不良性溃疡2例,糖尿病性溃疡6例。病程2个月~3年。创面范围3 cm × 2 cm~12 cm × 9 cm。6例伴骨、肌腱外露。扩创后先行封闭式负压引流培养新鲜肉芽组织,然后移植人工真皮,待类真皮组织形成后移植自体刃厚皮片封闭创面。 结果患者住院时间33~50 d,平均42 d。溃疡均顺利愈合,无严重并发症发生。患者均获随访,随访时间6~24个月。创面皮片色泽良好,质地柔软,耐磨,无明显挛缩或继发功能障碍;溃疡无复发。 结论联合应用封闭式负压引流与人工真皮移植治疗下肢慢性溃疡简便易行、安全有效。

    Release date:2016-08-31 04:08 Export PDF Favorites Scan
  • APPLICATION OF VACUUM SEALING DRAINAGE IN SEVERE SKIN CLOSED INTERNAL DEGLOVING INJURY

    【Abstract】 Objective To investigate the effectiveness of the vacuum sealing drainage (VSD) technique with split middle thickness skin replantation for the treatment of severe skin closed internal degloving injury (CIDI). Methods Between July 2008 and April 2011, 16 patients with severe skin CIDI were treated. There were 11 males and 5 females, aged 17-56 years (mean, 28 years). Injury was caused by traffic accident in all cases. The time between injury and operation was 2-8 hours (mean, 5 hours). Peeling skin parts included the upper limb in 3 cases and the lower limb in 13 cases. The range of skin exfoliation was 5%-12% (mean, 7%) of the body surface area with different degree of skin contamination. After thorough debridement, exfoliative skin was made split middle thickness skin graft for in situ replantation, and then VSD was performed. Results After 7 days of VSD therapy, graft skin survived successfully in 14 cases; partial necrosis of graft skin occurred in 2 cases, and was cured after thorough debridement combined with antibiotics for 7 days. All patients were followed up 6-18 months (mean, 12 months). The appearance of the limb was satisfactory without obvious scar formation, and the blood supply and sensation were normal.The joint function was normal. Conclusion For patients with severe skin CIDI, VSD treatment combined with split middle thickness skin replantation can improve the local blood circulation of the limb, promote replantation skin survival, and shorten healing time of wound. The clinical effectiveness is satisfactory.

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 改良封闭式负压引流技术在骨科创面治疗中的应用

    【摘 要】 目的 通过与常规封闭式负压引流技术(vacuum sealing drainage,VSD)进行比较,探讨改良VSD在骨科创面治疗中的优越性。 方法 2008年3月-2010年4月,共治疗37例42处创面,其中17例20处创面采用常规VSD治疗(常规组);20例22处采用改良VSD治疗(改良组),即在常规VSD敷料中加入1根冲洗管,进行持续灌注冲洗。两组患者性别、年龄、病程、创面部位及创面范围等一般资料比较,差异均无统计学意义(P gt; 0.05),具有可比性。 结果 改良组泡沫敷料维持时间较常规组长(t=2.70,P=0.01)。常规组术后15例(88%)进行注射器冲管,改良组仅1例(5%),差异有统计学意义(χ2=3.80,P=0.04)。改良组术后更换泡沫敷料次数为(1.0 ± 0.1)次,较常规组(2.2 ± 0.6)次少(t=2.90,P=0.01)。改良组费用为(6 330 ± 550)元,较常规组(12 990 ± 1 120)元少(t=2.70,P=0.01)。 结论 改良VSD延长了泡沫敷料使用时间,减少了患者更换敷料的次数,降低了治疗费用。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 封闭式负压引流技术治疗复杂性骶尾部褥疮疗效观察

    目的 总结封闭式负压引流(vacuum sealing drainage,VSD)技术治疗复杂性骶尾部褥疮的疗效。 方法2009年10月-2011年6月,收治6例复杂性骶尾部褥疮患者。男5 例,女1例;年龄33~72岁,平均47岁。褥疮根据美国褥疮指导小组(NPUAP)分期标准均为Ⅳ期。既往有2~24次褥疮修复史。前次复发后至此次入院时间为1~8个月,平均4.5个月。褥疮范围12 cm × 10 cm~17 cm × 13 cm。患者经2~3次VSD治疗(5~7周)后,直接拉拢缝合关闭创面,继续VSD治疗7~9 d。 结果5例骶尾部创面愈合良好;1例骶部遗留表皮缺损,经换药1周后愈合。患者均获随访,随访时间6~18个月,平均13个月。骶尾部皮肤生长良好,褥疮未复发。 结论VSD治疗复杂性骶尾部褥疮具有操作简便、创伤小等优点。

    Release date:2016-08-31 04:21 Export PDF Favorites Scan
  • 封闭式负压引流联合游离股前外侧皮瓣修复Pilon骨折术后软组织缺损

    目的 总结封闭式负压引流(vacuum sealing drainage,VSD)联合游离股前外侧皮瓣移植修复Pilon骨折术后软组织缺损的疗效。 方法2008年3月-2011年7月,收治Pilon骨折术后软组织缺损患者23例。男15例,女8例;年龄16~63岁,平均32.2岁。Pilon骨折术后至此次手术时间为1~6个月,平均3.2个月。创面伴骨、钢板螺钉外露,创面范围9 cm × 5 cm~13 cm × 7 cm。VSD治疗后,切取大小为10 cm × 6 cm~15 cm × 9 cm的游离股前外侧皮瓣移植修复创面。供区直接缝合(6例)或游离植皮(17例)修复。 结果术后3例皮瓣发生静脉危象,其余皮瓣均顺利成活,创面Ⅰ期愈合。供区切口均Ⅰ期愈合,皮片除1例出现边缘部分坏死外,其余均成活。23例均获随访,随访时间6~24个月,平均11.5个月。皮瓣质地柔软,外形、色泽好。术后6个月踝关节功能按照美国矫形足踝协会(AOFAS)评分系统评定:获优11例,良8例,可3例,差1例;优良率为82.6%。 结论应用VSD联合游离股前外侧皮瓣修复Pilon骨折术后软组织缺损,可缩短治疗周期,提高手术成功率,最大限度恢复肢体功能。

    Release date:2016-08-31 04:22 Export PDF Favorites Scan
  • 持续封闭式负压引流治疗严重软组织损伤致出血的临床观察

    目的 总结持续封闭式负压引流(vacuum sealing drainage,VSD)治疗严重软组织损伤过程中发生创面大量快速出血的原因。 方法 2008 年8 月- 2011 年8 月,收治9 例四肢严重软组织损伤患者。男7 例,女2 例;年龄25 ~ 51 岁,平均39.2 岁。损伤原因:电烧伤2 例,交通事故伤6 例,其他伤1 例。创面污染及软组织损伤严重;伴动脉损伤6 例,神经损伤6 例,骨筋膜室综合征3 例,骨折7 例。伤后至入院时间1 ~ 12 h,平均3.5 h。入院后急诊清创,对应处理合并伤后行VSD 治疗。 结果 患者于VSD 治疗后7 ~ 14 d 出现数分钟内吸出大量血性液体,拆开VSD 敷料见创面新鲜肉芽组织少,动脉血管壁及移植血管糜烂、破溃出血。再次彻底清创止血后,7 例采用皮瓣或皮片修复后创面愈合;2 例截肢。 结论 VSD 治疗严重软组织损伤出现创面大量快速出血,与损伤严重程度及部位有关。对于伴主要血管、神经严重损伤的四肢,尤其关节周围软组织损伤慎用VSD 治疗。

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • 封闭式负压引流技术联合腓动脉穿支皮瓣修复足踝部皮肤软组织缺损

    目的 总结封闭式负压引流技术(vacuum sealing drainage,VSD)联合腓动脉穿支皮瓣修复皮肤软组织缺损的方法及临床疗效。 方法 2009 年2 月- 2011 年1 月,收治11 例足踝部皮肤软组织缺损患者。男7 例,女4 例;年龄18 ~ 60 岁,平均37.2 岁。交通事故伤8 例,重物砸伤2 例,爆炸伤1 例。损伤部位:足踝2 例,足跟及跟腱部3 例,足背6 例。创面范围为3.5 cm × 3.0 cm ~ 13.5 cm × 9.0 cm。受伤至手术时间为2 ~ 8 h,平均4.5 h。先行VSD 治疗,待创面肉芽组织新鲜、感染控制后,采用大小为5 cm × 4 cm ~ 15 cm × 11 cm 的腓动脉穿支皮瓣修复创面。供区直接缝合或游离植皮修复。 结果 皮瓣修复术后1 例出现皮瓣切口远端皮缘坏死,1 例出现静脉危象,经对症处理后成活;其余皮瓣均顺利成活,创面Ⅰ期愈合。11 例均获随访,随访时间7 ~ 24 个月,平均13 个月。皮瓣色泽外形好,质地佳,局部无明显瘢痕挛缩,耐磨性良好,皮瓣受力处无破溃。末次随访时,踝关节功能采用美国矫形足踝协会(AOFAS)评分系统进行评价,获优7 例,良2 例,可1 例,差1 例,优良率为81.8%。 结论 VSD 治疗能降低创面感染几率,促进肉芽生长,为皮瓣修复提供良好条件。腓动脉穿支皮瓣是修复足踝部皮肤软组织缺损的有效方法之一。

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
  • EFFECTIVENESS OF VACUUM SEALING DRAINAGE COMBINED WITH ANTI-TAKEN SKIN GRAFT FORPRIMARY CLOSING OF OPEN AMPUTATION WOUND

    Objective To observe the effectiveness of vacuum seal ing drainage (VSD) combined with anti-takenskin graft on open amputation wound by comparing with direct anti-taken skin graft. Methods Between March 2005 andJune 2010, 60 cases of amputation wounds for limbs open fractures were selected by using the random single-blind method.The amputation wounds were treated with VSD combined with anti-taken skin graft (test group, n=30) and direct anti-takenskin graft (control group, n=30). No significant difference was found in age, gender, injury cause, amputation level, defect size,preoperative albumin index, or injury time between 2 groups (P gt; 0.05). In test group, the redundant stump skin was usedto prepare reattached staggered-meshed middle-thickness skin flap by using a drum dermatome deal ing after amputation,which was transplanted amputation wounds, and then the skin surface was covered with VSD for continuous negative pressuredrainage for 7-10 days. In control group, wounds were covered by anti-taken thickness skin flap directly after amputation, andconventional dress changing was given. Results To observe the survival condition of the skin graft in test group, the VSDdevice was removed at 8 days after operation. The skin graft survival rate, wound infection rate, reamputation rate, times ofdressing change, and the hospital ization days in test group were significantly better than those in control group [ 90.0% vs.63.3%, 3.3% vs. 20.0%, 0 vs. 13.3%, (2.0 ± 0.5) times vs. (8.0 ± 1.5) times, and (12.0 ± 2.6) days vs. (18.0 ± 3.2) days, respectively](P lt; 0.05). The patients were followed up 1-3 years with an average of 2 years. At last follow-up, the scar area and grading, and twopointdiscrimination of wound in test group were better than those in control group, showing significant differences (P lt; 0.05).No obvious swelling occurred at the residual limbs in 2 groups. The limb pain incidence and the residual limb length were betterin test group than those in control group (P lt; 0.05). Whereas, no significant difference was found in the shape of the residual limbs between 2 groups (P gt; 0.05). In comparison with the contralateral limbs, the muscle had disuse atrophy and decreasedstrength in residual limbs of 2 groups. There was significant difference in the muscle strength between normal and affected limbs(P lt; 0.05), but no significant difference was found in affected limbs between 2 groups (P gt; 0.05). Conclusion Comparedwith direct anti-taken skin graft on amputation wound, the wound could be closed primarily by using the VSD combined withanti-taken skin graft. At the same time it could achieve better wound drainage, reduce infection rate, promote good adhesion ofwound, improve skin survival rate, and are beneficial to lower the amputation level, so it is an ideal way to deal with amputationwound in the phase I.

    Release date:2016-08-31 04:23 Export PDF Favorites Scan
5 pages Previous 1 2 3 4 5 Next

Format

Content