Kiyokawa Kensuke, Takahashi Nagahiro, Rikimaru Hideaki, Yamauchi Toshihiko, Inoue Yojiro
Kurume City, Japan From the Department of Plastic and Reconstructive Surgery, Kurume University School of Medicine.
Plast Reconstr Surg. 2007 Oct;120(5):1257-1265. doi: 10.1097/01.prs.0000279332.27374.69.
Continuous irrigation and the vacuum-assisted closure system are effective methods for the treatment of infected wounds and intractable ulcers. The objective of this study was to simultaneously use both of the above methods as a new approach for obtaining more satisfactory, accelerated wound healing.
After debridement of the wound, indwelling irrigation and aspiration tubes are placed in the wounds that have been sutured closed. With open wounds, a sponge with the same shape as the wound is placed directly onto the wound surface, and after the two tubes are inserted in the sponge, the wound is covered with film dressing to make the wound completely airtight. A bottle of physiologic saline solution is then attached to the irrigation tube, and a continuous aspirator (Mera Sacume) is attached to the aspiration tube. The bottle of physiologic saline solution is placed at the same height as the wound, and with a pressure gradient between the two of 0, continuous aspiration is applied.
All nine cases treated as closed air cavity wounds with this method healed after 2 to 3 weeks. In eight cases of open wound, recurrence of infection was observed in only one case.
The two treatments of continuous irrigation and negative pressure were observed to have an additive and synergistic effect for earlier wound healing. Furthermore, the present method can dramatically reduce the number of dressing changes required, patient pain, psychological stress, and treatment cost.
持续冲洗和负压封闭引流系统是治疗感染伤口和顽固性溃疡的有效方法。本研究的目的是同时使用上述两种方法，作为一种新的方法来获得更满意、加速伤口愈合的效果。
伤口清创后，将留置冲洗和吸引管放置在已缝合关闭的伤口中。对于开放性伤口，将一块与伤口形状相同的海绵直接放置在伤口表面，在将两根管子插入海绵后，用薄膜敷料覆盖伤口，使伤口完全密封。然后将一瓶生理盐水连接到冲洗管上，并将连续吸引器（Mera Sacume）连接到吸引管上。将生理盐水瓶放置在与伤口相同的高度，两者之间的压力梯度为0，进行持续吸引。
用这种方法作为封闭气腔伤口治疗的所有9例患者在2至3周后均愈合。在8例开放性伤口中，仅1例观察到感染复发。
观察到持续冲洗和负压这两种治疗方法对早期伤口愈合具有相加和协同作用。此外，本方法可以显著减少所需的换药次数、患者疼痛、心理压力和治疗成本。
