【摘要】目的探讨持续封闭负压引流(vacuum-sealing drainage，VSD)技术治疗四肢皮肤及软组织由多种病因引起的难治性感染创面的临床效果。方法对2009年9月～2011年9月临床收治的16例复杂难治性皮肤软组织感染创面行手术清创，应用VSD敷料覆盖创面，应用病房中心负压引流装置持续吸引治疗7～14 d后，拆除敷料行二期植皮或皮瓣转移术。结果16例患者中9例经5～7 d VSD封闭引流,创面行自体中厚皮片植皮术成活。4例感染较重并伴有骨折患者,再一次清创后,继续VSD引流7 d后肉芽组织鲜活平整,予以直接游离缝合并配合植皮,创口封闭，移植皮肤基本成活。3例感染重皮肤软组织缺损较多者行临近皮瓣移植覆盖后配合常规换药并成活。结论VSD能较好清除创面的分泌物和坏死组织，刺激肉芽生长，有助于控制创面感染，明显缩短皮肤软组织缺损的治疗时间，极大的减轻患者的痛苦，临床疗效显著。

    【关键词】皮肤软组织缺损；难治性创面；治疗；持续封闭负压引流The clinical application of VSD vacuum sealing drainage technology in the treatment of limbs refractory wound infection WANG Ye-wu，CHEN Nan，JIN Yu-mei，ZHU Xiao-song，LI Qing,DING Zhong-yun.The First-affiliated Hospital of Kunming Medical College, Kunming 650031,China

    【Abstract】ObjectiveTo investigation the clinical effects of continuous vacuum-assisted closure (vacuum-sealing drainage,VSD) in the treatment of limb skin and soft tissue caused by a variety of causes of refractory wound infection.Methods16 patients with complex clinical skin and soft tissue infections from September 2009 to September 2011 were treated through surgical debridement.Application of continuous vacuum assisted closure dressing covering the wound,Application of centers negative pressure drainage device ward continue to attract 7-14 d.Removal of the dressing line two skin graft or skin flap.ResultsIn 16 patients,9 patients after 5-7 d VSD closed drainage,wounds with grafting skin graft survival.4 cases of severe infection and in patients with fractures,once again, after debridement,Continue VSD drainage 7 d,fresh granulation tissue formation.Be a direct free skin graft suture and tie,wound closure,the basic survival of transplanted skin.Three cases of infection are more severe skin and soft tissue defects were survival after the line near the cover flap with conventional dressing time.ConclusionVSD can completely remove the wound secretions and necrotic tissue,stimulate the growth of granulation,help to control wound infection.Significantly shorten the treatment of skin and soft tissue defects of the time,greatly reduce the suffering of patients,the clinical effect is significant.【Key words】Soft tissue；Defects Refractory wound；Treatment；Continuous vacuum-sealing drainage骨科感染创面的治疗是骨科临床上经常遇到的问题 ......