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负压封闭引流技术在头颈部创面愈合障碍治疗中的应用:23 例回顾性分析。

Vacuum assisted closure in the management of wound healing disorders in the head and neck: a retrospective analysis of 23 cases.

机构信息

Department of Otolaryngology and Head and Neck Surgery, Ludwig Maximilians University, Munich, Germany.

出版信息

Am J Otolaryngol. 2013 Sep-Oct;34(5):411-5. doi: 10.1016/j.amjoto.2013.03.001. Epub 2013 Apr 1.

Abstract

BACKGROUND

Since the middle of the 1990s vacuum-assisted closure (VAC) has been used in many areas of surgery to manage complex wounds and impaired wound healing. Until recently, little attention has been paid to this treatment modality in the field of head and neck surgery. The evaluation of its efficacy in wound healing disorders of the head and neck was the aim of this study.

MATERIAL AND METHODS

Patients with complex wounds and impaired healing treated with VAC therapy between 2008 and 2011 were included into the study. VAC dressings were changed every 3 days and improvements in wound healing were documented.

RESULTS

23 patients were treated with VAC therapy, in 18 cases (78%) closure of the defect could be reached without any further surgical procedure. 5 patients needed subsequent regional flap reconstruction to close the remaining defect. All of these patients had undergone salvage surgery in a previously irradiated neck before.

CONCLUSION

Vacuum assisted closure is an effective treatment in the management of wound healing disorders and complex wounds in the head and neck. It offers a useful, non-invasive modality to close even large defects in the area. Previous irradiation seems to have a significant negative influence on the outcome of the therapy, but more data are required to assess these effects.

摘要

背景

自 20 世纪 90 年代中期以来,真空辅助闭合(VAC)已在许多外科领域中用于治疗复杂伤口和伤口愈合不良。直到最近,在头颈部外科领域,人们对这种治疗方式关注甚少。本研究旨在评估其对头颈部伤口愈合障碍的疗效。

材料和方法

纳入 2008 年至 2011 年间采用 VAC 治疗的复杂伤口和愈合不良的患者。每 3 天更换 VAC 敷料,并记录伤口愈合的改善情况。

结果

23 例患者接受 VAC 治疗,18 例(78%)无需进一步手术即可封闭缺损。5 例患者需要后续进行区域性皮瓣重建以闭合剩余的缺损。这些患者均在之前放疗过的颈部进行了挽救性手术。

结论

真空辅助闭合是治疗头颈部伤口愈合障碍和复杂伤口的有效方法。它提供了一种有用的、非侵入性的方法,可以闭合该区域的大缺损。先前的放疗对治疗效果有显著的负面影响,但需要更多的数据来评估这些影响。

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