Application of self-made vacuum sealing drainage device in postoperative fixation and drainage of abdominal pedicled flaps in 8 patients with deep burns of upper limbs
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摘要: 2013年1月—2017年12月,笔者单位收治8例上肢深度烧伤患者,其中男6例、女2例,年龄23~48岁。Ⅲ~Ⅳ度创面面积为4.5 cm×2.0 cm~20.0 cm×10.5 cm,清创后用5.0 cm×2.5 cm~22.0 cm×12.0 cm大小腹部带真皮下血管网薄皮瓣覆盖,供区直接减张缝合。将一次性吸痰管侧方剪孔用作引流管,用纳米银抗菌敷料包裹引流管剪孔部分后置于腹部皮瓣蒂部与供瓣区的最低位以及患肢与腹壁的间隙中,用松散的纳米银抗菌敷料团填塞各个指蹼间以及患肢与腹壁的间隙,用透明薄膜敷料封闭术区后接低负压电动吸引器,以-15~-10 kPa负压行持续吸引。每隔4~5天更换一次自制负压封闭引流装置,直至术后2~3周行断蒂术。8例患者的腹部带蒂皮瓣均未发生扭转、撕脱,未出现蒂部血供障碍,术区未发生感染或皮肤浸渍、糜烂,断蒂后皮瓣全部成活。Abstract: From January 2013 to December 2017, 8 patients with deep burns of upper limbs were admitted to our hospital, including 6 males and 2 females, aged 23-48 years. The wound area of full-thickness burns to burns with tendon and bone injury was 4.5 cm×2.0 cm-20.0 cm×10.5 cm. After debridement, thin abdominal flaps with subdermal vascular network in the size of 5.0 cm×2.5 cm-22.0 cm×12.0 cm were applied to cover the wounds, and the donor sites were sutured directly by relaxation. The disposable suction tubes with holes cut on side walls were used as drainage tubes. The part of drainage tubes with holes were wrapped with nano-silver antimicrobial dressings and then placed at the lowest position of pedicle and donor site of abdominal flap and the space between the injured limb and the abdominal wall. The loose nano-silver antibacterial dressing was used to fill the webs of fingers and the gap between the injured limb and the abdominal wall. The transparent film dressing was used to close the surgical area and then connected with a low negative voltage electric suction device to continuously suck at a negative pressure of -15 to -10 kPa. The self-made vacuum sealing drainage device was replaced at intervals of 4 to 5 days until pedicle breakage was performed 2 to 3 weeks after operation. The pedicled abdominal flaps of 8 patients had no torsion or avulsion, no pedicle blood supply disorder, and no infection or skin erosion in the operation area, and all the flaps survived after pedicle breakage.
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Key words:
- Burns /
- Surgical flaps /
- Negative-pressure wound therapy /
- Equipment design
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