摘要
目的探讨采用负压封闭引流术（vacuum sealing drainage, VSD）联合穿支皮瓣分期治疗小腿糖尿病性溃疡的临床应用效果。方法2013年8月至2015年8月,对21例确诊为小腿糖尿病性溃疡的患者，在血糖控制稳定的前提下，一期彻底扩创后持续VSD负压吸引，二期利用穿支皮瓣修复创面。结果所有创面在彻底扩创VSD负压吸引后二期行穿支皮瓣修复，其中19例术后皮瓣完全成活，2例出现皮瓣远端1/4-1/5面积皮肤坏死，予以清创换药后愈合良好。随访所有患者血糖控制平稳，皮瓣均成活良好，无软组织感染及骨髓炎等并发症。结论在血糖控制稳定的基础上，采用VSD联合穿支皮瓣分期治疗小腿糖尿病性溃疡的方法，能达到控制感染、闭合创面的目的，在临床上值得应用推广。
Objective To investigate the effect of staging treatment for diabetic leg ulcer by vacuum sealing drainage surgery （VSD） combined with perforator flap.MethodsFrom Aug. 2013 to Aug. 2015, 21 patients （in glycemic stability） with diabetic leg ulcer received the sustained VSD suction after a thorough debridement at the first phase and used perforator flap to repair the wound at second phase.
ResultsAfter a thorough debridement and the sustained VSD suction, all the wounds were repaired with perforator flaps at the second phase. Postoperative flaps of 19 cases survived completely. Postoperative flaps of 2 cases appeared 1/4-1/5 area necrosis of distal flap and healed well after clear debridement. All patients were followed up in glycemic stability and all the flaps survived well without complications such as osteomyelitis and soft tissue infection.ConclusionBased on glycemic stability, VSD combined perforator flap in treatment of diabetic leg ulcers can control the infection and wound closure, which is worthy of clinical application and promotion.
出处
《中华内分泌外科杂志》
CAS
2017年第3期207-209,214,共4页
Chinese Journal of Endocrine Surgery
基金
浙江省科技厅公益类项目（2015C33195）
