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损伤控制性外科在尾骨深部褥疮合并脓毒症患者中的应用。

Application of damage control surgery in patients with sacrococcygeal deep decubitus ulcers complicated by sepsis.

机构信息

Department of Burn Intensive Care Unit, Quanzhou First Hospital, Quanzhou City, Fujian Province, P.R. China.

Department of Emergency, Quanzhou First Hospital, Quanzhou City, Fujian Province, P.R. China.

出版信息

J Int Med Res. 2021 Oct;49(10):3000605211049876. doi: 10.1177/03000605211049876.

Abstract

OBJECTIVE

To evaluate the clinical application of damage control surgery (DCS) in patients with sacrococcygeal deep decubitus ulcers complicated by sepsis.

METHODS

We conducted a 3-year retrospective clinical study of 32 patients with deep sacrococcygeal bedsores and sepsis admitted from January 2018 to January 2021. According to the concept of DCS, the wound was temporarily closed with vacuum sealing drainage after primary debridement, and a local rhomboid flap was designed to repair the wound in the second stage. Finally, the clinical therapeutic effect was observed.

RESULTS

Twenty-nine patients were treated with skin flap translocation and were cured clinically. Specifically, the skin flap survived in 27 of the 29 patients after the first translocation attempt (success rate of 93.1%). One patient developed incisional dehiscence, and one patient developed a hydrocele under the skin flap.

CONCLUSIONS

Application of DCS in patients with sacrococcygeal deep decubitus ulcers complicated by sepsis improves the therapeutic success rate and reduces the risks of the operation and complication rate. It has unique advantages and is worthy of clinical promotion.

摘要

目的

评估损伤控制外科(DCS)在并发脓毒症的骶尾部深度褥疮患者中的临床应用。

方法

我们对 2018 年 1 月至 2021 年 1 月期间收治的 32 例骶尾部深度褥疮并发脓毒症的患者进行了 3 年回顾性临床研究。根据 DCS 理念,初次清创后,采用真空密封引流暂时封闭伤口,二期设计局部菱形皮瓣修复创面。最后观察临床治疗效果。

结果

29 例患者采用皮瓣移位治疗,临床治愈。具体来说,在 29 例患者中,有 27 例患者的皮瓣在首次移位尝试中存活(成功率为 93.1%)。1 例患者发生切口裂开,1 例患者皮瓣下出现积液。

结论

DCS 在并发脓毒症的骶尾部深度褥疮患者中的应用,提高了治疗成功率,降低了手术风险和并发症发生率。具有独特的优势,值得临床推广。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/720c/8562640/9402c3543633/10.1177_03000605211049876-fig1.jpg

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