封閉式負壓引流術聯合游離植皮及皮瓣移植術治療感染創面的效果及對疼痛程度的影響

[摘 要]目的 探究封閉式負壓引流術聯合游離植皮及皮瓣移植術治療感染創面的效果及對疼痛程度的影響。方法 選取天津市中西醫結合醫院/天津市南開醫院整形修復外科2020年7月-2023年7月收治的70例感染創面患者為研究對象，采用隨機數字表法分為對照組和觀察組，各35例。對照組采取常規創面修復治療，觀察組采取封閉式負壓引流術聯合游離植皮及皮瓣移植術治療，比較兩組臨床相關指標、疼痛程度、創面愈合情況、并發癥發生情況。結果 觀察組創面換藥次數少于對照組，抗感染藥物使用時間、創面愈合時間、總治療時間短于對照組（P<0.05）；兩組植皮/移植前及拆線當日VAS評分低于治療前，且觀察組低于對照組（P<0.05）；觀察組創面愈合優良率為97.14%，高于對照組的80.00%（P<0.05）；觀察組并發癥發生率為0，低于對照組的5.71%，差異無統計學意義（P>0.05）。結論 封閉式負壓引流術聯合游離植皮及皮瓣移植術治療感染創面的效果確切，可為新生肉芽生長提供良好條件，能改善臨床相關指標，緩解患者疼痛，促進創面愈合，且不增加并發癥發生率，值得臨床應用。

[關鍵詞] 感染創面；封閉式負壓引流術；游離植皮；皮瓣移植術

[中圖分類號] R641 [文獻標識碼] A [文章編號] 1004-4949（2024）21-0033-04

Effect of Vacuum Sealing Drainage Combined with Free Skin Grafting and Flap Transplantation in the Treatment of Infected Wounds and its Effect on Pain Degree

BIAN Quan

（Plastic and Reconstructive Surgery Department of Tianjin Hospital of ITCWM/Nankai Hospital， Tianjin 300000， China）

[Abstract]Objective To explore the effect of vacuum sealing drainage combined with free skin grafting and flap transplantation in the treatment of infected wounds and its influence on the degree of pain. Methods A total of 70 patients with infected wounds admitted to the Plastic and Reconstructive Surgery Department of Tianjin Hospital of ITCWM/Nankai Hospital from July 2020 to July 2023 were selected as the research objects. They were divided into control group and observation group by random number table method， with 35 patients in each group. The control group was treated with routine wound repair， and the observation group was treated with vacuum sealing drainage combined with free skin grafting and flap transplantation. The clinical related indexes， pain degree， wound healing and complications were compared between the two groups. Results The number of wound dressing changes in the observation group was less than that in the control group， and the use time of anti-infective drugs， wound healing time and total treatment time were shorter than those in the control group （P<0.05）. The VAS score of the two groups before skin grafting/transplantation and on the day of suture removal was lower than that before treatment， and that of the observation group was lower than that of the control group （P<0.05）. The excellent and good rate of wound healing in the observation group was 97.14%， which was higher than 80.00% in the control group （P<0.05）. The incidence of complications in the observation group was 0， which was lower than 5.71% in the control group， and the difference was not statistically significant （P>0.05）. Conclusion Vacuum sealing drainage combined with free skin grafting and flap transplantation is effective in the treatment of infected wounds， which can provide good conditions for the growth of new granulation， improve clinical related indicators， relieve pain， promote wound healing， without increasing the incidence of complications. It is worthy of clinical application.

[Key words] Infected wounds； Vacuum sealing drainage； Free skin grafting； Flap transplantation

創面是多種原因導致的開放性損傷，若沒有及時給予治療干預，會增加患者治療周期，且患者的疼痛較為明顯，嚴重危害其身心健康[1]。感染創面多由疾病或外傷所致，受感染因素影響，局部軟組織損傷明顯，常規換藥、清創難以改善，導致創面遷延不愈[2]。……