跟腱外露难愈创面的封闭式负压吸引治疗

《跟腱外露难愈创面的封闭式负压吸引治疗》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、跟腱外露难愈创面的封闭式负压吸引治疗跟腱外露难愈创面的封闭式负压吸引治疗［摘要］目的：总结封闭式负压引流(vacuum-assistedclosure,VAC)技术治疗跟腱外露创面的良好效果，为这类创面修复提供更好的治疗方法。方法：2007年1月〜2014年3月，笔者应用VAC治疗18例跟腱外露患者，其中跟腱断裂术后9例，车祸伤4例，重物卡压伤2例，钢绳切割伤1例，III度烧伤1例，III度电击伤1例。围手术期准备后，尽快手术扩创，行创面VAC治疗。结果：所有创面经VAC治疗后，创面明显缩小，肉芽生长迅速，部分或全部覆盖外露肌腱，其中12例全部被肉芽组织覆盖，

2、行薄中厚皮片移植修复，11例患者一期愈合。余仍有部分肌腱外露者，5例行邻近皮瓣修复，全部一期愈合；1例行人工真皮加自体刃厚皮片移植一次性修复，所有创面一期愈合率达94.4%o所有患者均随访6月〜3年，无复发，局部无挛缩，功能恢复良好。结论：VAC治疗跟腱外露难愈创面，明显缩短疗程，有效防治肌腱坏死，减少手术创伤及治疗疼痛，提高愈合质量。［关键词］封闭式负压引流；跟腱；创面；肉芽组织［中图分类号1R622［文献标识码］A［文章编号:1008-6455(2014)14-1139-04Vacuum-assistedclosuretreatmentofachilles

3、tendonexposedrefractorywoundsLIUFei,ZHANGChen-wei,LINHai-bo,GUOZheng-dong,WangYan,HONGHao,LUOKai,QINWang-chi,YANGWei-guo,LIANGZhi(DepartmentofPlasticandCosmeticSurgery,NanshanAffiliatedHospitalofGuangDongMedicalCollege,Shenzhen518052,Guangdong,China)Abstract：ObjectiveTosummarizether

4、esultofvacuum-assistedclosure(VAC)treatmentofAchillestendonexposedrefractorywounds,andprovidedabettermethodtotreatthesewounds・MethodsEighteenpatientswithAchillestendonexposedrefractorywounds,hospitalizedfromJanuary2007toMarch2014,weretreatedwithVAC・Thetendonofpostoperativewoundinfec

5、tionofskinsofttissuenecrosis(9cases),caraccidentinjuryskinandsofttissuedefect(4cases),heavyconformityofskinsofttissuenecrosis(2cases),steelcordcuttinginjuryskinandsofttissuedefect(2cases),third-degreeburn(1cases),third-degreeelectricalinjury(leases)・Allthepatientsweregivensystemicsu

6、pportingtreatmentinperioperativeperiodandearlydebridement,andweretreatedwithVAC・ResultsAfterVACtreatment,allwoundssignificantlyreduced,thefreshgranulationtissueformedrapidlyinallcases,someorallofthecoveringexposedtendons,12patientswereallcoveredwithgranulationtissueexposedtendons・12

7、caseswiththinthicknessskingrafttorepair,11patientswereprimaryhealing；5patientswithadjacentflaprepair,allpatientswereprimaryhealing；1patientswithartificialdermisandautologoussplit-thicknessskingraftone-timerepair,allwoundprimaryhealingratewas94.4%.Allpatientswerefollowedupfor6monthst

8、o3years,norecurrenc