Department of Plastic and Reconstructive Surgery, Loma Linda University Medical Center, Loma Linda, CA 92354, USA.
J Plast Reconstr Aesthet Surg. 2009 Nov;62(11):1428-36. doi: 10.1016/j.bjps.2008.06.033. Epub 2008 Oct 4.
This retrospective case series describes our experiences and outcomes using the vacuum-assisted closure (VAC) Therapy System for the management of difficult acute and chronic wounds in paediatric patients.
Difficult wounds that cannot be closed primarily can create major challenges in paediatric patient care. Decreasing the time to wound closure is especially critical when managing paediatric patients.
A retrospective review of medical records for 58 consecutive paediatric patients treated with VAC therapy was performed. Demographics, diagnosis, length of therapy, time to closure, time to discharge, type of VAC dressing used, dressing change schedule, therapy settings, and complications were recorded for each patient.
The median age of all 58 patients was 10 years (range, 10 days to 16 years). Fifty-four of the 58 wounds reached full closure. Patients were divided into five different groups according to diagnosis. The median time to closure for each group follows: Group 1 (abdominal wounds) 10 days (range, 3-99 days); Group 2 (surgical soft tissue deficit) 12 days (range, 3-30 days); Group 3 (trauma wounds) 7 days (range, 3-10 days); Group 4 (stage III/IV pressure ulcers) 15 days (range, 14-15 days); Group 5 (fasciotomy wounds) 5 days (range, 5-10 days). No complications were recorded for any of the patients.
The results demonstrate that VAC therapy may be a viable, safe and effective method of managing this difficult-to-treat population.
本回顾性病例系列描述了我们使用真空辅助闭合（VAC）治疗系统治疗儿科患者急慢性难愈性伤口的经验和结果。
无法一期缝合的难愈性伤口可能给儿科患者的护理带来重大挑战。在处理儿科患者时，缩短伤口闭合时间尤为关键。
对 58 例连续接受 VAC 治疗的儿科患者的病历进行回顾性分析。记录每位患者的人口统计学资料、诊断、治疗时间、愈合时间、出院时间、使用的 VAC 敷料类型、敷料更换时间表、治疗环境和并发症。
58 例患者的中位年龄为 10 岁（范围，10 天至 16 岁）。54 例 58 处伤口完全愈合。根据诊断，患者分为五组。每组的中位愈合时间如下：第 1 组（腹部伤口）为 10 天（范围，3-99 天）；第 2 组（手术软组织缺损）为 12 天（范围，3-30 天）；第 3 组（创伤伤口）为 7 天（范围，3-10 天）；第 4 组（Ⅲ/Ⅳ期压疮）为 15 天（范围，14-15 天）；第 5 组（筋膜切开伤口）为 5 天（范围，5-10 天）。所有患者均未发生并发症。
结果表明，VAC 治疗可能是治疗这一难处理人群的一种可行、安全且有效的方法。
