Argenta L C, Morykwas M J
Department of Plastic and Reconstructive Surgery, Bowman Gray School of Medicine, Winston-Salem, NC 27157-1075, USA.
Ann Plast Surg. 1997 Jun;38(6):563-76; discussion 577.
Despite numerous advances, chronic and other difficult-to-manage wounds continue to be a treatment challenge. Presented is a new subatmospheric pressure technique: vacuum-assisted closure (The V.A.C.). The V.A.C. technique entails placing an open-cell foam dressing into the wound cavity and applying a controlled subatmospheric pressure (125 mmHg below ambient pressure). Three hundred wounds were treated: 175 chronic wounds, 94 subacute wounds, and 31 acute wounds. Two hundred ninety-six wounds responded favorably to subatmospheric pressure treatment, with an increased rate of granulation tissue formation. Wounds were treated until completely closed, were covered with a split-thickness skin graft, or a flap was rotated into the health, granulating would bed. The technique removes chronic edema, leading to increased localized blood flow, and the applied forces result in the enhanced formation of granulation tissue. Vacuum-assisted closure is an extremely efficacious modality for treating chronic and difficult wounds.
尽管取得了诸多进展，但慢性伤口及其他难以处理的伤口仍然是治疗上的一大挑战。本文介绍了一种新的负压技术：真空辅助闭合疗法（V.A.C.）。V.A.C.技术是将开孔泡沫敷料置于伤口腔内，并施加可控的负压（低于环境压力125毫米汞柱）。共治疗了300个伤口：175个慢性伤口、94个亚急性伤口和31个急性伤口。296个伤口对负压治疗反应良好，肉芽组织形成率增加。伤口持续接受治疗，直至完全闭合，或覆盖断层皮片，或将皮瓣旋转至健康、有肉芽组织生长的伤口床。该技术可消除慢性水肿，增加局部血流，所施加的力会促使肉芽组织的形成增强。真空辅助闭合疗法是治疗慢性和难愈伤口的一种极其有效的方法。
