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负压封闭引流疗法促进严重下肢缺血手术血运重建术后伤口愈合。

VAC therapy to promote wound healing after surgical revascularisation for critical lower limb ischaemia.

作者信息

De Caridi Giovanni, Massara Mafalda, Greco Michele, Pipitò Narayana, Spinelli Francesco, Grande Raffaele, Butrico Lucia, de Franciscis Stefano, Serra Raffaele

机构信息

Cardiovascular and Thoracic Department, 'Policlinico G. Martino' Hospital, University of Messina, Messina, Italy.

Department of Surgical and Medical Science, University Magna Graecia of Catanzaro, Catanzaro, Italy.

出版信息

Int Wound J. 2016 Jun;13(3):336-42. doi: 10.1111/iwj.12301. Epub 2014 May 28.

Abstract

Vacuum-assisted closure (VAC) therapy is a new emerging non-invasive system in wound care, which speeds up wound healing by causing vacuum, improving tissue perfusion and suctioning the exudates, and facilitating the removal of bacteria from the wound. The application of sub-atmospheric pressure on the lesions seems to alter the cytoskeleton of the cells on the wound bed, triggering a cascade of intracellular signals that increase the rate of cell division and subsequent formation of granulation tissue. The aim of this study is to analyse the results of VAC therapy used as an adjuvant therapy for the treatment of foot wounds in patients affected by critical limb ischaemia (CLI) (Rutherford 6 class) after distal surgical revascularisation, to promote and accelerate the healing of ulcers. Twenty-nine patients (20 males, 9 females; mean age 68·4) affected by CLI of Rutherford 6 class, after surgical revascularisation of the lower limb, underwent VAC therapy in order to speed up wound healing. Complete wound healing was achieved in 19 patients (65·51%), in an average period of 45·4 ± 25·6 days. VAC therapy is a valid aid, after surgical revascularisation, to achieve rapid healing of foot lesions in patients with CLI.

摘要

负压封闭引流(VAC)疗法是伤口护理中一种新兴的非侵入性系统,它通过产生负压、改善组织灌注和抽吸渗出物,并促进伤口细菌清除来加速伤口愈合。对伤口施加负压似乎会改变伤口床细胞的细胞骨架,引发一系列细胞内信号,从而提高细胞分裂速率并随后形成肉芽组织。本研究的目的是分析VAC疗法作为辅助治疗手段,用于治疗严重肢体缺血(CLI)(卢瑟福6级)患者在远端手术血运重建后足部伤口的效果,以促进和加速溃疡愈合。29例卢瑟福6级CLI患者在下肢手术血运重建后接受了VAC疗法以加速伤口愈合,其中男性20例,女性9例,平均年龄68.4岁。19例患者(65.51%)实现了伤口完全愈合,平均用时45.4±25.6天。VAC疗法是一种有效的辅助手段,可在手术血运重建后帮助CLI患者实现足部伤口的快速愈合。

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