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目的探讨负压封闭式引流(VSD)技术在“5.12”汶川大地震所致骨筋膜室综合征切开减压中的应用。方法回顾性研究了自2008年5月12日～2008年6月1日,接受VSD治疗的15例汶川地震伤员18个患肢。术后记录引流量,肢体肿胀消退情况以及全身发热等症状。根据肢体肿胀程度及肉芽生长情况,采用延期缝合、植皮或者皮瓣转移覆盖创面。结果 15例术后病情得到迅速控制,负压引流量在520～2360ml之间。术后7d内有10个创面肿胀消退,肉芽组织新鲜。余下8个创面经过第二次更换VSD敷料,5处筋膜室切开减压创面肿胀消退,肉芽新鲜。经第三次更换VSD敷料后余下3处创面肿胀消退,肉芽新鲜,予闭合创口。上述切开减压创面无一例发生感染。结论地震致骨筋膜室综合征经早期切开减压结合VSD治疗能快速覆盖创面,减少污染,防止继发感染;能有效引流分泌物,减少毒素吸收;减轻肢体水肿,促进新鲜肉芽生长,利于创面修复。
Objective To investigate the application of negative pressure closed drainage (VSD) technique in incision decompression of osteofascial compartment syndrome caused by the “5.12 ” Wenchuan Earthquake. Methods A retrospective study was conducted on 15 affected limbs in Wenchuan Earthquake from May 12, 2008 to June 1, 2008. Postoperative records of drainage, extremity swelling and systemic fever and other symptoms. According to the extent of limb swelling and granulation conditions, the use of delayed suture, skin graft or flap covering the wound. Results 15 cases of postoperative condition was quickly controlled, negative pressure drainage volume between 520 ~ 2360ml. Ten wounds subsided within 7 days and the granulation tissue was fresh. The remaining 8 wounds after the second replacement VSD dressing, 5 fascia ventricular decompression and pressure wound swelling subsided, granulation fresh. After the third replacement of VSD dressing, the wounds in the remaining 3 wounds subsided and the granulation was fresh. The wounds were closed and closed. None of the incision decompression wound infection occurred. CONCLUSIONS: Seismic compartment syndrome can be rapidly covered by VSD after early incision decompression combined with VSD to reduce the pollution and prevent secondary infection. It can effectively drain secretions and reduce toxin absorption, reduce body edema, promote the growth of fresh granulation, Benefit the wound repair.