标题：压疮皮瓣修复术后持续双负压微压力封闭引流的应用效果

      作者：叶东成，黄晓栋，牛占国，黄静，黄兆伦    东莞市人民医院烧伤整形外科，广东 东莞 523059

      卷次： 2019年30卷14期

      【摘要】 目的 探讨压疮皮瓣修复术后持续双负压微压力封闭引流的应用效果。方法 选择东莞市人民医院烧伤整形外科2016年1月至2018年12月期间收治的80例压疮患者为研究对象，根据随机数表法将患者分为对照组和观察组，每组40例。对照组患者采用皮瓣修复术+负压封闭引流术(VSD)治疗，观察组则应用皮瓣修复术+持续双负压微压力封闭引流术，出院时比较两组患者的引流量、皮瓣愈合时间、皮瓣远端坏死的发生率及切口裂开发生率。结果 观察组患者的创面引流量为(25.4±6.9) mL，明显高于对照组的(10.8±3.1) mL，皮瓣坏死及切口裂开发生率分别为2.5%和2.5%，均明显低于对照组的15.0%和12.5%，差异均有统计学意义(P<0.05)；观察组患者的皮瓣愈合及住院时间分别为(20.5±6.3) d、(28.3±8.6) d，明显短于对照组的(26.8±7.8) d、(33.2±10.4) d，差异均有统计学意义(P<0.05)。结论 压疮皮瓣修复术后应用持续双负压微压力封闭引流可以有效促进皮瓣愈合，减少皮瓣远端坏死及切口裂开的发生率。
      【关键词】 压疮；皮瓣修复术；负压封闭引流技术；皮瓣坏死；疗效
      【中图分类号】 R63 【文献标识码】 A 【文章编号】 1003—6350（2019）14—1807—03

Application effect of double-layer continuous negative pressure sealing drainage under micro-pressure after flaprepair surgery of pressure ulcer.
YE Dong-cheng, HUANG Xiao-dong, NIU Zhan-guo, HUANG Jing, HUANGZhao-lun. Department of Burn and Plastic Surgery, Dongguan People's Hospital, Dongguan 523059, Guangdong, CHINA
【Abstract】 Objective To investigate the effect of double layer continuous negative pressure sealing drainageunder micro-pressure after flap repair surgery of pressure ulcer. Methods A total of 80 patients with pressure ulcer ad-mitted to the Department of Burn and Plastic Surgery at Dongguan People's Hospital from January 2016 to December2018 were selected as the research subjects. According to the random number table method, these patients were dividedinto a control group and an observation group, with 40 cases in each group. The control group was treated with flap re-pair and vacuum sealing drainage (VSD), and the observation group was treated with flap repair and double-layer contin-uous micro-pressure VSD. At the time of discharge, the drainage volume, healing time of skin flaps, incidence of distalflap necrosis, and the rupture rate in incision were compared between the two groups. Results In the observationgroup, the wound drainage volume was (25.4±6.9) mL, which was significantly higher than (10.8±3.1) mL in the controlgroup; the incidence of skin flap necrosis and cleft incision were respectively 2.5% and 2.5%, which were significantlylower than corresponding 15.0% and 12.5% in the control group; all differences were statistically significant (P<0.05).The healing and hospitalization time in the observation group were (20.5±6.3) days and (28.3±8.6) days, respectively,which were significantly shorter than corresponding (26.8±7.8) days and (33.2±10.4) days in the control group (P<0.05).Conclusion The use of double layer continuous negative pressure sealing drainage with micro-pressure after flap re-pair surgery of pressure ulcer can effectively promote the healing of skin flap and reduce the incidence of distal necrosisand incision dehiscence.
      【Key words】 Pressure ulcer; Flap repair surgery; Negative pressure sealing drainage; Flap necrosis; Curativeeffect