目的：探讨封闭负压引流技术在大面积烧伤患者后期感染难愈创面治疗方面的效果。方法：回顾性分析2011年9月至2014年8月我院收治的后期创面感染难愈的大面积烧伤患者17例，扩创+刃厚自体邮票皮移植或常规换药治疗1周后效果不佳，采用扩创植皮联合封闭负压引流技术修复创面，治疗第3天行创面分泌物细菌培养，观察皮片成活率，治疗第6天停用封闭负压引流治疗，观察并记录创面愈合率，此后进行常规换药至创面全部愈合，观察治疗期间的换药痛感，并记录创面完全愈合的时间。结果：扩创植皮联合封闭负压引流治疗后3 d，创面分泌物培养4例耐甲氧西林金黄色葡萄球菌阳性，皮片的成活率平均为83.9%；治疗后6 d，创面愈合率平均为85.7%。治疗期间换药时患者疼痛程度较前明显减轻。17例患者创面均于入院后36～49 d完全愈合。结论：封闭负压引流治疗是大面积烧伤后期合并感染难愈合创面的有效治疗方法，可明显提高移植皮片成活率，促进创面愈合。
The application of vacuum sealing drainage in the treatment of infection wound healing at later stage of large area burn
Objective: Study of the effect of vacuum sealing drainage in the treatment of infection wound healing at later stage of large area burn. Methods: A retrospective analysis of 17 patients with refractory infection wounds at later stage of large area burn from September 2011 to August 2014. Debridement + blade thickness from 1 week after treatment ineffective stamp body skin transplantation or conventional dressing, using debridement and skin grafting combined with vacuum-assisted closure wound repair. Treatment of the first three days the line wound secretions bacterial culture, the concept of survival Chapi sheet, 6 days of treatment disable VAC therapy, wound healing rate was observed and recorded. After which regular dressing to the wound healed, the dressing was observed during treatment pain, and the wound is completely healed record time. Results: 3 days of debridement and skin grafting combined with vacuum sealing drainage after treatment, 4 cases of wound secretion culture of methicillin resistant staphylococcus aureuspositive, skin graft survival rate was 83.9% in average; 6 days after treatment, the wound healing rate was 85.7%. During the treatment of patients with pain relief was significantly reduced compared with the previous. A total of 17 patients were healed after 36~49 d. Conclusion: Vacuum assisted closure therapy is effective in treatment at large area burn wound infection; vacuum assisted closure therapy can significantly improve the skin graft survival rate, and promote wound healing.