目的 探讨负压封闭引流(vacuum sealing drainage, VSD)在大面积烧伤患者创面修复中的疗效。方法 我院2009-03至2012-03收治60例大面积烧伤患者，随机分为VSD治疗组30例和常规治疗组30例，前者清创后给予VSD负压吸引，后者行非手术换药治疗，两组均在创面新鲜，形成肉芽后分期分批行头部取皮游离植皮修复创面，比较两组疗效。结果 VSD治疗组无创面脓毒症患者肉芽生长时间(9.05±2.95) d、植皮成活率（90.12±4.88）%、创面愈合时间（60.25±11.75）d；创面脓毒症患者肉芽生长时间（10.23±1.77）d、植皮成活率（86.48±2.52）%、创面愈合时间(64.52±7.48) d，2例死亡。常规治疗组无创面脓毒症患者肉芽生长时间(14.78±5.22) d、植皮成活率(70.05±9.95)%、创面愈合时间(80.16±10.84) d；创面脓毒症患者肉芽生长时间(16.15±3.85)d、植皮成活率(65.14±4.86)%、创面愈合时间(85.03±5.97)d，死亡8例。结论 VSD可控制大面积烧伤患者创面感染，促进肉芽组织生长，提高植皮成活率，缩短创面愈合时间，降低病死率。
Abstract
Objective To evaluate the clinical curative effect of applying vacuum sealing drainage (VSD) therapy in treating extensive burns. Methods The medical records of 60 extensive burn patients admitted to this hospital from March 2009 to March 2012 were retrospectively analyzed. Grouped according to the treatment, 30 cases of VSD group received vacuum aspiration after debridement ,and 30 cases of conventional therapy group received conservative dressing. In both groups with fresh wound and after formation of granulation,the skin was taken from the head free skin, was grafted to repair the burn wound. Results In VSD group, in patients without wound sepsis ,the granulation time was (9.05±2.95)d , the skin graft survival rate was （90.12±4.88）%,and time of wound healing was （60.25±11.75）d;in patients with wound sepsis ,the granulation time was （10.23±1.77）d, skin graft survival rate was （86.48±2.52）%, and wound healing time was (64.52±7.48) d, and two cases died.In the conventional treatment group, in patients without wound sepsis, the granulation time was (14.78±5.22) d, skin graft survival rate was (70.05±9.95)%, wound healing time was (80.16±10.84) d ; in patients with wound sepsis ,the granulation time was (16.15±3.85)d, skin graft survival rate was (65.14±4.86)%, wound healing time was (85.03±5.97)d, and five cases died.The differences were tatistically significant (P<0.05). Conclusions Compared with conventional dressing, VSD controls the wound infections, promotes the growth of granular tissues, increases graft survival rate, shortens the healing time of wound, enhances the patients’ general conditions, and reduces the rate of complications and mortality.
关键词
负压封闭引流 /
大面积烧伤 /
创面愈合
Key words
vacuum sealing drainage;extensive burn patients /
wound healing
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(2012-07-23
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