负压封闭引流技术在四肢血管损伤患者中的应用

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目的:探讨负压封闭引流技术(vacuumsealingdrainage,VSD)在血管损伤患者接受血管吻合后创面应用的治疗效果。方法2011年1月至2013年10月,我院治疗的61例四肢血管损伤患者,通过直接吻合或血管移植进行治疗,其中33例血管吻合口周围创面无法一期关闭,以周围组织覆盖血管吻合口后将VSD应用于血管吻合口周围创面及远端减张创面,而另外28例血管吻合口创面可直接关闭,远端减张创面应用VSD覆盖。结果本组61例中,6例因各种原因而保肢失败,最终截肢治疗,其余55例创面通过游离植皮或者皮瓣而得到关闭,在应用VSD治疗过程中未出现严重不良事件。结论负压封闭引流技术在血管损伤患者中应用可获得良好治疗效果,对血管吻合口以周围组织覆盖后应用持续负压吸引未引发吻合口痉挛或者堵塞。“,”Objective To investigate the effects of vacuum sealing drainage ( VSD ) technique to repair the wounds of the patients with vascular injuries in extremities who were treated with vascular anastomosis. Methods From January 2011 to October 2013, 61 patients with vascular injuries in extremities were treated in our hospital, all of whom underwent direct vascular anastomosis or vascular graft. The wounds around vascular anastomosis could not be closed by ifrst intention in 33 patients. Vascular anastomosis was covered by surrounding tissues and the VSD technique was used in the wounds around vascular anastomosis and in the distal wounds of decompression. In the other 28 patients the wounds around vascular anastomosis were closed directly, and the VSD technique was used in the distal wounds of decompression. Results Limb salvage treatment failed in 6 cases due to various reasons, and amputation was performed ifnally. The wounds in the other 55 cases were closed by free skin graft or the lfap. In the process of VSD treatment, serious adverse events were not found. Conclusions The VSD technique is a good choice in the treatment of the patients with vascular injuries in extremities, with excellent therapeutic effects. Anastomotic spasm or vascular embolization will not be caused by continuous negative pressure attraction, after the vascular anastomosis was covered by surrounding tissues.
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