目的 探讨外科手术联合真空负压封闭引流(vacuum sealing drainage,VSD)技术治疗儿童锁骨骨髓炎的治疗效果.方法 收集2012年1月至2016年1月我院收治的9例儿童锁骨骨髓炎患儿,男6例,女3例;年龄1.2~10岁,平均3.5岁.其中8例为血源性感染,1例为锁骨骨折内固定术后出现感染.所有患儿均在术前进行血培养,术中脓液培养及骨质病理检查.所有患儿均行彻底清创,创腔常规置管行无菌生理盐水冲洗、持续负压吸引,将VSD装置中高分子泡沫合成敷料剪成与病灶清除后创腔大小,再将引流管与皮肤垂直穿出,同时接VSD负压吸引装置,并根据药敏试验结果选择敏感抗生素;冲洗液清亮、感染指标正常后拆除VSD装置更换负压引流球,复查血常规、CRP、红细胞沉降率等感染指标连续2次正常、冲洗液连续培养2次阴性后改为口服抗生素出院.出院后1个月、3个月和6个月进行随访,了解患儿伤口和骨质恢复情况.结果 9例锁骨骨髓炎患儿治疗27~38天,更换VSD敷料1~2次;9例患儿术后随访6~49个月,平均19个月.经手术治疗后均未出现引流管脱出、渗漏,锁骨骨感染得到有效控制,随访期间未再出现感染.结论 局部开窗、置管冲洗引流联合VSD技术能够有效治疗儿童锁骨骨髓炎,并且并发症较少,适于在医院中推广应用.“,”Objective To investigate the curative results of surgery combined with vacuum sealing drainage ( VSD ) in the treatment of children with clavicular osteomyelitis. Methods A total of 9 children with clavicular osteomyelitis adopted from January 2012 to January 2016 were included in this study. There were 6 males and 3 females, whose average age was 3.5 years old ( range: 1.2 - 10 years ). Among them, there were 8 cases of hematogenous infection and 1 case of infection after internal fixation due to clavicle fracture. All the patients were treated with blood culture before surgery, pus culture and pathological examination during the surgery. All the patients underwent thorough debridement, conventional tube flushing with sterile saline in the wound cavity and continuous suction. The synthesis of polymer foam dressing of the VSD device was cut into the same size as the wound cavity after debridement and drainage which was perpendicular to the skin piercing, and then was connected with the VSD pressure suction device. The sensitive antibiotics were chosen according to the results of drug sensitivity test. The rinse was clear. The VSD device was removed after the infection index became normal, with the replacement of negative pressure drainage ball. When the infection indicators of blood routine, C-reactive protein ( CRP ) and erythrocyte sedimentation rate ( ESR ) were normal for 2 consecutive times, and the culture results with washing liquid were negative for 2 consecutive times, the patients were treated with oral antibiotics and discharged. The patients were followed up at the 1st months, 3rd months and 6th months after discharge, so as to find their wound and sclerotin recovery conditions. Results Nine patients with clavicle osteomyelitis were treated for 27 - 38 days, with the replacement of VSD dressing for 1 - 2 times. Nine patients were followed up for an average period of 19 months ( range: 6 - 49 months ). After surgery, clavicle bone infection was effectively controlled. No infection occurred during the follow-up, without drainage tube prolapse or leakage. Conclusions The operation of local fenestration, tube drainage combined with VSD can effectively treat clavicle osteomyelitis in children with fewer complications, which should be promoted to apply in the hospital.