Ni Jianqiang, Liu Hongzhi, Liu Xiaoyang, Zhou Lugang, Sun Yujie, Shi Peng, Hao Wei, Su Hao, Wang Xin
From the Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China.
Medicine (Baltimore). 2015 Oct;94(43):e1766. doi: 10.1097/MD.0000000000001766.
Vacuum sealing is a therapeutic concept to achieve secure and rapid wound healing in traumatic soft tissue damage. Its application and effect in the treatment of severe buttocks and perianal infection are unclear.We describe a case of buttocks and perianal infection using the vacuum sealing drainage (VSD) technique. A 58-year-old man was admitted with buttocks and perianal severe infection, which was caused by injection. The size of the wounds was 40 × 30 cm. Colostomy was applied prior to the prompt surgical debridement to prevent defecation and keep the perianal region clean. Emergency debridement was then conducted. After the wounds were thoroughly washed with conventional disinfection solution, they were then covered by VSD system.The infection was controlled 9 days after the first surgery by prompt surgical debridement, the application of VSD treatment, and the use of narrow-spectrum antibiotics based on susceptibility result. After 3 applications of VSD treatment, skin grafting harvested from the left leg was conducted. All free skin grafts survived at 8 weeks. Colon was placed back into the abdominal cavity finally.Initial colostomy and debridement, the temporary VSD cover followed after several days by skin grafting is a reliable treatment regimen for severe buttocks and perianal infection.
负压封闭引流是一种用于创伤性软组织损伤，实现安全快速伤口愈合的治疗理念。其在严重臀部及肛周感染治疗中的应用及效果尚不清楚。我们描述了一例采用负压封闭引流（VSD）技术治疗臀部及肛周感染的病例。一名58岁男性因注射导致臀部及肛周严重感染入院。伤口大小为40×30厘米。在进行及时的手术清创前先行结肠造口术，以防止排便并保持肛周区域清洁。随后进行急诊清创。伤口用常规消毒溶液彻底冲洗后，再用VSD系统覆盖。通过及时的手术清创、应用VSD治疗以及根据药敏结果使用窄谱抗生素，首次手术后9天感染得到控制。经过3次VSD治疗后，取自左腿的皮肤进行了移植。所有游离皮片在8周时均存活。最后将结肠放回腹腔。初次结肠造口术和清创，数天后采用临时VSD覆盖，随后进行皮肤移植，是治疗严重臀部及肛周感染的可靠治疗方案。
