王晓雁等

[摘要] 目的 探讨负压封闭引流（VSD）技术联合刃厚皮片植皮治疗感染性皮肤缺损的治疗效果。方法 回顾性分析该院2012—2014年收治的60例（实验组）皮肤缺损伴发感染患者，植皮前先行清创VSD覆盖，细菌培养，使用敏感药物，待细菌培养阴性，皮肤创面大量肉芽组织生长时，行VSD联合刃厚皮片植皮。选取同时期60例感染性皮肤缺损患者作为对照组，行传统游离植皮术，比较疗效。结果 实验组发热反应发生率为5.0%，术后窦道形成率为10.0%，对照组发热反应发生率为16.7%，术后窦道形成率为20.0%。比较差异有统计学意义（P<0.05）。 结论 负压封闭引流技术具有较高的临床应用价值，值得推广。

[关键词] 皮肤缺损；负压封闭引流技术；刃厚皮片植皮

[中图分类号] R64 [文献标识码] A [文章编号] 1674-0742（2015）03（a）-0014-02

Effect Observation of VSD Combined with Split-thickness Skin Graft in the Treatment of Skin Defects with Infection

WANG Xiaoyan LI Xiang ZHANG Shihua ZHANG Shixu

Bone Traumatology， Yunnan Qujing First People's Hospital， Qujing， Yunnan Province， 655000 China

[Abstract] Objective To investigate the effect of vacuum sealing drainage （VSD） combined with split-thickness skin graft for the treatment of infectious skin defect. Methods A retrospective analysis was conducted on 60 cases（experimental group） with skin defect and infection admitted in our department from 2012 to 2014. The experimental group were given debridement and VSD coverage， sensitive drugs based on the germiculture and VSD combined with split-thickness skin graft when the result of bacterial culture was negative and a lot of granulation tissues grew on the wound. The other 60 cases with skin defect and infection admitted during the same period were selected as the control group and given the traditional free skin grafting. The curative effect was compared between the two groups. Results The incidence of fever was 5.0% and postoperative sinus formation rate was 10.0% in the experimental group， and that was 16.7%， 20.0%， respectively in the control group， the differences between the two groups were statistically significant （P<0.05）. Conclusion Vacuum sealing drainage has high value of clinical application， which is worthy of promotion.

[Key words] Skin defect； Vacuum sealing drainage； Split-thickness skin graft

感染创面在以往治疗中常采用反复换药，控制感染，待肉芽组织生长良好时行皮片植皮或组织皮瓣移植，但疗程较长，感染不易控制[1]。为探讨负压封闭引流（VSD）技术联合刃厚皮片植皮治疗感染性皮肤缺损的治疗效果，该院自2012年以来应用封闭负压吸引（VSD）联合刃厚皮片植皮治疗感染性创面，疗效满意，现报道如下。

1 资料与方法

1.1 一般资料

该组患者60例为到该就诊的皮肤缺损伴感染患者，其中男性45例，女性15例，年龄18～57岁。致伤原因为：车祸伤30例，压砸伤20例，其它10例。合并骨折患者19例。皮肤缺损面积最少1处，最多5处，最小面积8 cm×7 cm，最大面积12 cm×40 cm。选取同时期60例感染性皮肤缺损患者作为对照组，其中男性44例，女性16例，年龄19～58岁。致伤原因为：车祸伤31例，压砸伤19例，其它10例。合并骨折患者18例。皮肤缺损面积最少1处，最多5处，最小面积7 cm×7 cm，最大面积13 cm×40 cm。……