程　鹏，姜　平，潘伯骁，吴键学



·论著·

臀部皮瓣术后VSD辅助切口愈合的临床研究

程鹏，姜平，潘伯骁，吴键学

【摘要】目的研究臀部皮瓣术后应用VSD(负压封闭吸引)辅助切口愈合的效果。方法笔者选择南方医科大学附属南方医院整形美容外科2013年10月～2014年12月因压疮行臀部皮瓣手术治疗的患者16例(观察组)，术后行封闭负压吸引辅助固定；选择同一医院2012年8月～2013年10月因压疮接受臀部皮瓣手术治疗，术后棉垫绷带包扎固定的18例患者(对照组)，比较两组一次手术成功率、并发症发生率、创面愈合时间及住院时间。结果观察组一次手术成功率和并发症发生率分别为93.75%和6.25%，与对照组的61.11%、38.89%比较差异有统计学意义(P<0.05)。两组创面愈合时间[(20.45±2.36)VS(29.29±5.04)d]、住院时间[(28.78±4.16)VS(35.63±3.27)d]比较差异有统计学意义(P<0.05)。结论臀部皮瓣手术后应用VSD辅助固定和加压能促进切口愈合，显著提高一次手术成功率，减少并发症，值得临床推广。

【关键词】压疮； 臀部皮瓣； 负压封闭引流； 愈合

Clinical study of the effect of vacuum sealing drainage in assisting wound healing after hip flap surgery

CHENGPeng1，JIANGPing1，PANBo-xiao3，WUJian-xue3

(1.Southern Medical University，Guangzhou510515，China； 2.Department of Plastic & Aesthetic Surgery,Nanfang Hospital,Southern Medical University,Guangzhou510515; 3.Department of Burns Wounds and Ulcers,Huangpu People’s Hospital,Zhongshan528429,China)

【Abstract】ObjectiveTo investigate the effect of wound healing of vacuum sealing drainage(VSD)in assisting wound healing after hip flap surgery. MethodsSixteen sore patients who received hip flap surgery in Nanfang Hospital of Southern Medical University from Oct.2013 to Dec.2014 were selected as the observation group,who were fixed by using VSD after operation;eighteen sore patients who received hip flap surgery in the same hospital from Aug. 2012 to Oct.2013 were selected as the control group,who were fixed by using pad bandage. The surgical success rate,complication rate,wound healing time and hospitalization time of two groups were compared. ResultsIn the observation group,the surgical success rate and complication rate were 93.33%,6.67%,respectively,which was statistically different when compared with the control group(61.11%, 38.89%). In addition,there were statistical differences in the time of wound healing(20.45±2.36)vs.(29.29±5.04)d and the time of hospitalization(28.78±4.16)vs.(35.63±3.27)d. ConclusionThe auxiliary fixation and compression of VSD after hip flap surgery can promote wound healing and significantly improve the success rate of operation as well as reduce the complications,which is worthy of clinical application.

【Key words】 sore; hip flap; VSD; healing

作者单位： 510515 广东 广州，南方医科大学(程鹏)； 510515 广东 广州，南方医科大学附属南方医院整形美容外科(姜平)； 528429 广东，中山市黄圃人民医院烧伤创疡科(潘伯骁，吴键学)

臀部压疮主要由长时间卧床引起，其发生率在我国人口老龄化加速、长期卧床(如髋部骨折、脑血管疾病)病人增多情况下逐年上升。压疮给患者带来痛苦，影响生活质量，若发生严重感染并发脓毒血症可危及生命。中重度压疮自愈性差，需要用皮瓣来修复创面[1]。臀部皮瓣可采用的手术方式较多,如臀大肌皮瓣、股后皮神经营养血管皮瓣、阔筋膜张肌皮瓣及各种形式的筋膜皮瓣等[2]。术后要求俯卧位，但很少患者能维持2h，常以左右侧卧位为主。频繁(2h/次)更换卧位使皮瓣与皮瓣下方组织产生剪切力导致不粘连，并且容易牵拉皮瓣导致切口裂开，影响手术效果[3]。……