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山东大学学报(医学版) ›› 2014, Vol. 52 ›› Issue (7): 102-105.doi: 10.6040/j.issn.1671-7554.0.2014.123

• 临床医学 • 上一篇    下一篇

负压辅助闭合技术在儿童损毁性创面中的临床应用

尚念胜1,2, 霍然1, 吕仁荣1, 徐广琪1, 赵冉1   

  1. 1. 山东大学附属省立医院烧伤整形科, 山东 济南 250021;
    2. 淄博市职业病防治院烧伤整形科, 山东 淄博 255012
  • 收稿日期:2014-03-10 修回日期:2014-05-30 出版日期:2014-07-10 发布日期:2014-07-10
  • 通讯作者: 霍然。E-mail:huoran@medmail.com.cn E-mail:huoran@medmail.com.cn

Clinical application of vacuum assisted closure technology in children with damaged wounds

SHANG Niansheng1,2, HUO Ran1, LÜ Renrong1, XU Guangqi1, ZHAO Ran1   

  1. 1. Department of Burn and Plastic Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China;
    2. Department of Burn and Plastic Surgery, Zibo Occupational Disease Hospital, Zibo 255012, Shandong, China
  • Received:2014-03-10 Revised:2014-05-30 Online:2014-07-10 Published:2014-07-10

摘要: 目的 探讨负压辅助闭合技术(VAC)在治疗儿童损毁性创面中的临床应用及效果。方法 对14例儿童的损毁性创面进行彻底清创,使用VAC持续低负压吸引创面(-25~-125 mmHg,1 mmHg=0.133 kPa),每5~7 d更换1次VAC敷料;肉芽组织生长良好时,取刃厚皮片或中厚皮片植皮,继续应用VAC持续负压吸引,5~7 d后去除VAC敷料,观察植皮成活情况。结果 14例患儿创面肉芽组织均生长良好,其中12例植皮完全成活;1例皮片边缘少许坏死伴渗液,经换药愈合;1例创面未植皮,自行愈合。结论 VAC能有效促进儿童损毁性创面肉芽组织生长,促进基底血运改善,提高植皮成活率,加快创面愈合,减轻患儿痛苦,值得临床推广。

关键词: 儿童, 负压辅助闭合技术, 植皮术, 损毁性创面

Abstract: Objective To explore the clinical application and curative effect of vacuum assisted closure (VAC) in children with damaged wounds. Methods Primary debridement and VAC technique (-25 to -125 mmHg, 1 mmHg=0.133 kPa) were applied to the damaged wounds of 14 children. The VAC dressing was changed every 5 to 7 days. Razor thin skin graft or intermediate split thickness skin graft were conducted when abundant granulation tissue was observed. Wounds after skin grafting were still covered by VAC dressing for 5 to 7 days, and then survival rate of grafted skin was measured and recorded. Results Abundant granulation tissues were observed in all the 14 wounds. Grafted skin survived well in 12 wounds. Partial necrosis was seen in one grafted wound, which healed well after simple treatment. The other wound epithelized spontaneously without skin grafting. Conclusion VAC technique can promote the growth of granulation tissue, improve the blood flow to the wound, increase the survival rate of grafted skin, accelerate the wound healing, and ease the suffering of children. It is worthy of popularizing and applying in clinic.

Key words: Children, Skin graft, Damaged wound, Vacuum assisted closure technology

中图分类号: 

  • R622.1
[1] Morykwas M J, Argenta L C, Shelton-Brown E I, et al. Vacuum-assisted closure: a new method for wound control and treatment: animal studies and basic foundation[J]. Ann Plast Surg, 1997, 38(6):553- 562.
[2] 肖军, 邱林, 傅跃先, 等. 封闭式负压引流技术在儿童感染创面修复中的应用[J]. 重庆医科大学学报, 2011, 36(7):875-877.
[3] Kasukurthi R, Borschel G H. Simplified negative pressure wound therapy in pediatric hand wounds[J]. Hand (N Y), 2010, 5(1):95-98.
[4] Atiyeh B S, El-Musa K A, Dham R. Scar quality and physiologic barric function restoration after moist and moist-exposed dressings of partial-thickness wounds[J]. Dermatol Surg, 2003, 29(1):14-20.
[5] Morykwas M J, Simpson J, Punger K, et al. Vacuum-assisted closure:State of basic research and physiological foundation[J]. Plast Reconstr Surg, 2006, 117(7):S121-S126.
[6] 蒋琪霞, 刘云, 徐薇, 等. 负压伤口治疗关键技术的研究进展[J]. 医学研究生报, 2007, 20(6):656-659.
[7] 周业平. 应用负压治疗创口的临床实践及进展[J]. 中华损伤与修复杂志, 2009, 4(1):10-12.
[8] 钱晓玲, 杨雪梅, 张选奋, 等. 负压伤口治疗关键技术的研究进展[J]. 甘肃医药, 2012, 31(11):839-841.
[9] Baharestani M, Amjad I, Bookout K, et al. V.A.C. Therapy in the management of pediatric wounds: Clinical review and experience [J]. Int Wounds J, 2009, 6(suppl 1):1-26.
[10] Mouse C M, van den Bemd G J, Heule F, et al. Comparing conventional gauze therapy to vacuum assisted closure wound therapy: a prospective randomised trial[J]. J Plast Reconstr Aesthet surg, 2007, 60(6):672-681.
[11] 刘飞, 林海波, 郭正东, 等.复杂难愈创面的封闭式负压吸引治疗[J]. 中华医学美学美容杂志, 2011, 17(6):470-471.
[12] 张海滨. 封闭负压辅助闭合技术在压力性溃疡治疗中的应用[J]. 中国老年学杂志, 2010, 30(10):1420-1421.
[13] 康映泉, 邱宏, 何少华, 等.负压封闭引流在儿童四肢软组织缺损治疗中的应用[J]. 创伤外科杂志, 2013, 15(5):425-427.
[14] Franczyk M, Lohman R F, Agarwal J P, et al. The impact of topical lidocaine on pain level assessment during and after vacuum-assisted closure dressing change: a double-blind, prospective, randomized study[J]. Plast Reconstr Surg, 2009, 124(3):854-861.
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