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1、封闭负压技术治疗各种术后伤口裂开［摘要］目的：观察封闭负压技术治疗外科手术后伤口裂开的临床效果及总结应用经验。方法:从2007年5月至2009年12月，采用封闭负压技术治疗各类外科术后伤口裂开患者17例，其中男10例，女7例，平均年龄41岁。创面面积为0.5cmX3.2cm〜5.5cmX18.6cm,创面形成时间为8〜94天，期间采用常规湿敷或中药换药治疗伤口未愈。给予-120mmHg〜T50mmHg负压持续吸引，治疗时间为6〜37天。结果：10例经封闭负压治疗后创面直接愈合，其余7例创面清洁，肉芽组织
2、新鲜，伤口缩小,4例清创缝合,2例行局部皮瓣转移,1例行皮片移植修复，伤口均一期愈合。术后随访2〜12个月，所有伤口愈合良好，无再次裂开。结论:封闭负压技术简便、无创，能有效促进伤口清洁，加快肉芽组织生长，缩短创面愈合时间，适合治疗各种外科术后伤口裂开，有较高的临床推广应用价值。［关键词］封闭负压技术;伤口裂开;创面愈合［中图分类号1R632E文献标识码］A［文章编号］1008-6455(2010)08-1117-03Vacuumassistedclosuretechniquefortreatingpo
3、stoperativewounddehiscencesLIJing,LVXiao-xing,JIANGLi,LIJin-qing,LIWang-zhou,CHENShao-zong,LIXue-yong,LIYue-jun(DepartmentofPlasticandBurnsSurgery,TangduHospital,theFourthMilitaryMedicalUniversity,Xi'an710038,Shaanxi,China)Abstract：ObjectiveTosummarizeth
4、emethodsandclinicaleffectoftreatingpostoperativewounddehiscenceswithVacuumAssistedClosure(VAC)technique.MethodsFromMay2007toDecember2009,VACwasemployedtotreat17patientswithwounddehiscencesafteroperationthatcouldnotbeclosedimmediately,ineluding10malesand7
5、femaleswithameanageof41yearsold.Thesizeofthewoundsrangedfrom0.5cmX3・2cmto5.5cmX18.6cm,andallthewoundshadbeenmanagedusingsaline-soakedgauzedressingsorthetraditionalChinesemedicinefor8to94dayswithnosignsofhealing.VACwasmaintainedonacontinuousmodewithanegat
6、ivepressureof-120mmHgto-150mmHg.Thewoundshadbeentreatedfor6daysto37days.ResuItsTenofthe17woundsachievedhealingdirectlyafterVACtherapy.Sevenotherwoundsdevelopedhealthygranulationtissueandcontractedsize・Stablecutaneouscoveragewereachievedbysurgicaldebridme
7、ntandsuture,localskinflaptransplantation,orskingrafting.Allthecaseswerefollowedupfor2monthsto12months・Noinfectionorreopeningofthewoundswereobserved.ConclusionsVACtechniqueissimple,noninvasiveandeffectiveinkeepingwoundclean,promotinggrowthofgranulationtis
8、sueandacceleratingwoundclosure・Soitdeservestobepopularizedfortreatingavarietyofwounddehiscences・Keywords：vacuumassistedclosure；wounddehiscence；woundhealing伤口裂开是外科手术后常见的并发症之一，形成的原因除了感染、血肿、积液、皮肤张力过大等局部因素外，还受患者全身情况的影响，如营养不良、免
