Hafeez Kamran, Kaim Khani Ghulam Mustafa, Kumar Darshan, Kumar Sunil
Dr. Kamran Hafeez, FCPS, Assistant Professor Orthopedics, Dow International Medical College, Dow University of Health Sciences, Ojha Campus Suparco Road, Karachi, Pakistan.
Dr. Haroon-ur-Rashid, FCPS, Assistant Professor Orthopedics, Aga Khan University Hospital, Stadium Road, Karachi, Pakistan.
Pak J Med Sci. 2015 Jan-Feb;31(1):95-9. doi: 10.12669/pjms.311.6093.
Vacuum assisted closure is a reported technique to manage complex wounds. We have utilized this technique by using simple locally available material in the management of our patients on outpatient basis. The objective of this study is to present our experience.
This study was conducted from June 2011 to June 2013 at Dow University Hospital and Aga Khan University Hospital, Karachi. There were 38 patients managed with vacuum assisted closure. Mean age was 56±7.8 years. Twenty three patients presented with necrotizing fasciitis and 15 patients with gangrene. Lower limbs were involved in majority of the patients. Debridement or amputations were done. Vacuum dressing was changed twice weekly in outpatient department. Wounds were closed secondarily if possible or covered with split thickness skin graft in another admission.
All the wounds were successfully granulated at the end of vacuum therapy. Mean hospital stay was 7.5 days. Vacuum dressing was applied for a mean of 20 days. There was reduction in the size of the wound. Thirteen patients underwent secondary closure of the wound under local anesthesia, 18 patients required coverage with split thickness skin graft and 7 patients healed with secondary intention.
Vacuum assisted closure appeared to be an effective method to manage complex diabetic wounds requiring sterile wound environment.
负压封闭引流是一种用于处理复杂伤口的技术。我们在门诊患者的治疗中利用简单的本地可得材料采用了该技术。本研究的目的是介绍我们的经验。
本研究于2011年6月至2013年6月在卡拉奇的道氏大学医院和阿迦汗大学医院进行。38例患者接受了负压封闭引流治疗。平均年龄为56±7.8岁。23例患者患有坏死性筋膜炎，15例患者患有坏疽。大多数患者累及下肢。进行了清创或截肢。在门诊每周更换两次负压敷料。如果可能，伤口二期缝合，或在另一次入院时用中厚皮片覆盖。
在负压治疗结束时，所有伤口均成功形成肉芽组织。平均住院时间为7.5天。负压敷料平均应用20天。伤口大小减小。13例患者在局部麻醉下进行了伤口二期缝合，18例患者需要用中厚皮片覆盖，7例患者二期愈合。
负压封闭引流似乎是处理需要无菌伤口环境的复杂糖尿病伤口的有效方法。
