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目的:探讨负压封闭引流技术(VSD)对慢性复杂创面愈合的治疗效果。方法:选取各类慢性复杂性创面患者共65例,病程均超过3个月,将65例患者随机分为VSD组(35例)及对照组(30例)。VSD组定期更换VSD辅料;2周后视创面愈合情况,选择继续VSD治疗,或行II期修复治疗(直接拉拢缝合,皮片移植,或皮瓣移植修复)。对照组的治疗采用常规换药,即以凡士林油纱布及无菌纱布覆盖创面,内置引流条,每12 h换药一次。两组创面于治疗前及治疗后各个时间点分别对比创面愈合率及创面组织细菌计数。结果:VSD治疗组患者全部愈合,治愈率达100%,对照组30例患者中治愈率为86.7%。两组治愈率相比无明显统计学差异(P>0.05)。VSD治疗组平均愈合时间为22±3.3天,对照组平均愈合时间为35±5.8天,两组愈合时间的差异具有统计学意义(P<0.01)。治疗后相同检测时间点VSD组创面细菌含量显著低于对照组,两组创面细菌含量的差异具有统计学意义(P<0.05)。结论:负压封闭引流技术(VSD)在提高慢性复杂创面的愈合率及清除创面细菌方面具有显著的效果。
Objective: To investigate the effect of negative pressure closed drainage (VSD) on healing of chronic complex wounds. Methods: A total of 65 patients with various types of chronic complex wounds were enrolled. The course of disease was over 3 months. 65 patients were randomly divided into VSD group (35 cases) and control group (30 cases). In the VSD group, the VSD excipients were changed regularly. After 2 weeks, the VSD treatment was continued or the wounds were treated with phase II repair (direct suture, skin graft or skin flap repair). The control group of the treatment of conventional dressing, that is, Vaseline gauze and sterile gauze covered wounds, built-in drainage strips, dressing change every 12 h. The wound healing rate and the bacterial count of wound tissue were compared between the two groups before treatment and at various time points after treatment. Results: The patients in the VSD group all healed with a cure rate of 100%. The cure rate of the 30 patients in the control group was 86.7%. There was no significant difference between the two groups in the cure rate (P> 0.05). The average healing time was 22 ± 3.3 days in VSD group and 35 ± 5.8 days in control group. There was significant difference between the two groups in healing time (P <0.01). After the treatment, the bacterial contents of wounds in the VSD group were significantly lower than those in the control group at the same test time point, and the bacterial contents in the two groups were statistically different (P <0.05). Conclusion: The negative pressure closed drainage technique (VSD) has a significant effect in improving the healing rate of chronic complex wounds and removing wound bacteria.