负压封闭引流技术治疗脊柱后路内固定术后切口感染效果观察

裴立家周新社李玉云①

(蚌埠医学院第一附属医院骨科安徽蚌埠233000；①蚌埠医学院检验系)

[摘要]①目的探讨和评价负压封闭引流( vacuum sealing drainage，VSD) 技术在脊柱内固定术后切口感染治疗中的临床疗效。②方法回顾分析本院9例脊柱后路内固定术后切口感染患者。每例患者应用VSD技术治疗，同时应用敏感抗生素，彻底清创并保留内置物。创面经过1～3次清创予以VSD敷料覆盖，每次引流7～10d，根据引流情况更换VSD敷料。③结果通过彻底清创，应用VSD处理创面联合抗生素治疗，3例患者经1次创面清创VSD应用，4例患者经2次创面清创VSD应用，2例患者经3次创面清创VSD应用，肉芽组织生长满意,缝合伤口。感染伤口治愈，内固定得以保留。④结论VSD 技术可有效控制脊柱后路内固定术后感染，利于伤口的早期愈合，内固定装置不需取出以维持脊柱稳定性。VSD技术治疗脊柱术后感染具有较好的临床疗效。

[关键词]负压封闭引流脊柱感染内固定

[中图分类号]R 74[文献标识码]A

【基金项目】安徽省高等学校省级自然科学研究项目(编号：Kj2012A198)。

【作者简介】裴立家(1985-)，男，硕士，住院医师。 研究方向：脊柱外科。

【通讯作者】周新社。

Negative pressure drainage technique in treatment of postoperative wound infection in patients with spinal posterior internal fixationPEILijia,ZHOUXinshe,LIYuyun,etal(DepartmentofOrthopedics,TheFirstAffiliatedHospitalofBengbuMedicalCollege,BengbuAnhui233000,China)

ABSTRACT[〗ObjectiveEvaluate vacuum sealing drainage(vacuum sealing drainage,VSD) technique in spinal internal fixation in the treatment of postoperative incision infection clinical curative effect.MethodsReview and analysis of our hospital,during the period of 9 cases of postoperative incision infection in patients with spinal posterior internal fixation.Each patient used the VSD treatment technology and application of sensitive antibiotics at the same time,thorough debridement and keep implants.Wound 1-3 times after debridement,VSD dressing drainage of 7-10 days at a time,according to the drainage condition change the VSD dressings.ResultsThrough thorough debridement,the application of VSD wound,with antibiotic therapy,three patients by 1 time wound debridement VSD application,2 times of wound debridement VSD application in 4 patients,2 patients after wound debridement VSD application three times,satisfactory suture the wound granulation tissue growth.Infected wounds heal,retention of the internal fixation.ConclusionThe VSD technique can effectively control postoperative

infection,spinal posterior internal fixation for early wound healing,internal fixation device maintain the stability of the spine.The VSD technical treatment of spinal postoperative infection has better clinical curative effect.

[KEYWORDS]Vacuum sealing drainage.Spine.Infection.Internal fixation

随着脊柱外科的发展，内固定在脊柱外科中广泛应用，同时由于脊柱手术数量、难度、时间逐渐增加，脊柱内固定术后感染时有发生。怎样迅速控制感染、保留脊柱内固定物、促进患者早日康复是脊柱术后切口感染面临的重要问题。我院在传统的清创换药、置管引流技术的基础上，应用负压封闭引流(VSD)技术，取得了良好效果，报告如下。……