The clinical effect of VSD technology in the treatment of high perianal abscess_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

REN Long ,  XIE Yixiang , WANG Chuansi , YAO Lei , HUANG Hongwu , WANG Yongsen , WU Yongjun

Department of Anorectal Surgery, The Affiliated Lu'an Hospital of Anhui Medical University, Lu'an, Anhui 237005, P.R.China;

Corresponding?author：

XIE Yixiang, Email: xieyx888@126.com

Keywords：

high perianal abscess; vacuum sealing drainage; closure of internal orifice; low incision combined with high thread operation

DOI：

10.7507/1007-9424.201608110

Video：

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Objective To evaluate the clinical effect of vacuum sealing drainage (VSD) technology in the treatment of high perianal abscess. Methods A total of 38 cases of high perianal abscess who underwent surgery in our hospital from May. 2014 to Feb. 2016 were randomly divided into 2 groups: the VSD group (n=19) and the control group (n=19). The cases of VSD group were performed with closure of internal orifice+VSD technique, and the cases of control group were treated with radical operation of perianal abscess (low incision combined with high thread operation). The following indexes of cases in 2 groups were compared and analyzed, including postoperative pain score, wound healing time, postoperative anal function score, and prognosis. Results There were significant differences in pain score (3.53±0.70vs. 5.11±0.74), postoperative anal function score (0vs. 1), and wound healing time〔(27.58±4.95) dvs. (44.68±6.53) d〕between VSD group and control group,P<0.05. Compared with the control group, the pain score and anal function score of the VSD group were both lower, and the wound healing time was shorter. However, there was no statistically significant difference in incidence of fistula between the two groups〔5.3% (1/19)vs. 15.8% (3/19),P=0.60〕. Conclusion In the treatment of high perianal abscess, VSD technology can relieve pain in patients, shorten the wound healing time, protect the anal function, and the prognosis is as well as low incision combined with high thread operation, so VSD is a better treatment method for high perianal abscess.

Citation： REN Long, XIE Yixiang, WANG Chuansi, YAO Lei, HUANG Hongwu, WANG Yongsen, WU Yongjun. The clinical effect of VSD technology in the treatment of high perianal abscess. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(3): 282-285. doi: 10.7507/1007-9424.201608110 Copy

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2.	王傳思, 謝貽祥. 半膠管引流Ⅰ期根治多間隙肛周膿腫的臨床研究. 結直腸肛門外科, 2011, 17(5): 328-330.
3.	王傳思, 謝貽祥. 熏洗Ⅰ號方治療肛周膿腫術后療效觀察. 四川中醫, 2011, 29(12): 91-92.
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5.	蔣琪霞, 劉云, 徐薇, 等. 負壓傷口治療關鍵技術的研究進展. 醫學研究生學報, 2007, 20(6): 656-659.
6.	陳雷. 肛周膿腫一次性根治術 120 例臨床分析. 吉林醫學, 2010, 31(22): 3744-3745.
7.	Senn S. Analysis of serial measurements in medical research. BMJ, 1990, 300(6725): 680.
8.	Modlin IM. Surgical triumvirate of Theodor Kocher, Harvey Cushing, and William Halsted. World J Surg, 1998, 22(1): 103-113.
9.	余洪艷, 韋俊武. 一期根治術治療小兒肛周膿腫 56 例臨床分析. 結直腸肛門外科, 2012, 18(6): 368-369.
10.	王巖, 李樹杰, 王軍, 等. 肛周膿腫一期手術治療臨床療效觀察(附 107 例報道). 中國普外基礎與臨床雜志, 2009, 16(9): 755-756.
11.	郭茂華, 袁月姣, 周錦都, 等. 高壓氧在重度肛周膿腫術后消炎促愈作用. 結直腸肛門外科, 2010, 16(3): 162-163.
12.	文家勇, 萬萍. 貝復濟在肛周膿腫術后換藥中的臨床療效觀察. 西藏醫藥雜志, 2005, 26(2): 27-28.
13.	紀鳳蘭, 張建華. 銀離子敷料用于肛周膿腫切開術后的臨床效果觀察. 中國醫藥導報, 2010, 7(27): 34-35.
14.	趙永嬌, 何穎華, 智建文, 等. 中醫祛腐生肌法換藥促進肛周膿腫、肛瘺術后患者創面愈合的臨床觀察. 北京中醫藥, 2011, 30(3): 203-204.
15.	Fleischmann W, Becker U, Bischoff M,et al. Vacuum sealing: indication, technique, and results. Eur J Orthop Surg Traumatol, 1995, 5(1): 37-40.
16.	Chen SZ, Li J, Li XY,et al. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg, 2005, 28(3): 211-217.
17.	許龍順, 陳紹宗, 喬騁, 等. 負壓對創面血流量的影響. 第四軍醫大學報, 2000, 21(8): 976-978.
18.	李靖, 陳紹宗, 李學擁, 等. 封閉負壓引流對創面微循環超微結構影響的實驗研究. 中國美容整形外科雜志, 2006, 17(1): 75-77.
19.	胡祥, 喻愛喜, 俞國榮, 等. 負壓封閉引流對創面細胞黏附分子-1 表達及 IkBα 磷酸化的影響. 中華實驗外科雜志, 2012, 29(1): 123-125.
20.	呂小星, 陳紹宗, 李學擁, 等. 封閉負壓引流技術對創周組織水腫及血管通透性的影響. 中國臨床康復, 2003, 7(8): 1244-1245.
21.	Squier CA. The effect of stretching on formation of myofibroblasts in mouse skin. Cell Tissue Res, 1981, 220(2): 325-335.
22.	Takei T, Mills I, Arai K,et al. Molecular basis for tissue expansion: clinical implications for the surgeon. Plast Reconstr Surg, 1998, 102(1): 247-258.
23.	Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Ann Plast Surg, 2004, 52(3): 276-280.
24.	Polykandriotis E, Kneser U, Kopp J,et al. Modified gloving technique for vacuum therapy in the hand. Zentrabl Chir, 2006, 131 Suppl 1: S36-S39.
25.	Thompson G. An overview of negative pressure wound therapy (NPWT). Br J Community Nurs, 2008, 13(6): S23-S24, S26, S28-S30.
26.	王聲政, 魏金星, 張雪培, 等. 負壓封閉引流技術在 Fournier 壞疽中的應用. 中華外科雜志, 2013, 51(11): 1044-1045.
27.	Murthi GV, Okoye BO, Spicer RD,et al. Perianal abscess in childhood. Pediatr Surg Int, 2002, 18(8): 689-691.
28.	方征宇, 潘志蕓, 李乾元, 等. VSD 在肛周膿腫術后創面應用的臨床觀察. 浙江臨床醫學, 2016, 18(6): 1071-1072.
29.	楊帆, 白祥軍. 負壓封閉引流 (VSD) 技術在各類創面的應用研究進展. 創傷外科雜志, 2011, 13(1): 82-84.

1. ?胡伯虎. 大腸肛門病治療學. 北京: 科學技術文獻出版社, 2004: 300-301.
2. 王傳思, 謝貽祥. 半膠管引流Ⅰ期根治多間隙肛周膿腫的臨床研究. 結直腸肛門外科, 2011, 17(5): 328-330.
3. 王傳思, 謝貽祥. 熏洗Ⅰ號方治療肛周膿腫術后療效觀察. 四川中醫, 2011, 29(12): 91-92.
4. 國家中醫藥管理局. 中醫病證診斷療效標準. 南京: 南京大學出版社, 1994: 132-133.
5. 蔣琪霞, 劉云, 徐薇, 等. 負壓傷口治療關鍵技術的研究進展. 醫學研究生學報, 2007, 20(6): 656-659.
6. 陳雷. 肛周膿腫一次性根治術 120 例臨床分析. 吉林醫學, 2010, 31(22): 3744-3745.
7. Senn S. Analysis of serial measurements in medical research. BMJ, 1990, 300(6725): 680.
8. Modlin IM. Surgical triumvirate of Theodor Kocher, Harvey Cushing, and William Halsted. World J Surg, 1998, 22(1): 103-113.
9. 余洪艷, 韋俊武. 一期根治術治療小兒肛周膿腫 56 例臨床分析. 結直腸肛門外科, 2012, 18(6): 368-369.
10. 王巖, 李樹杰, 王軍, 等. 肛周膿腫一期手術治療臨床療效觀察(附 107 例報道). 中國普外基礎與臨床雜志, 2009, 16(9): 755-756.
11. 郭茂華, 袁月姣, 周錦都, 等. 高壓氧在重度肛周膿腫術后消炎促愈作用. 結直腸肛門外科, 2010, 16(3): 162-163.
12. 文家勇, 萬萍. 貝復濟在肛周膿腫術后換藥中的臨床療效觀察. 西藏醫藥雜志, 2005, 26(2): 27-28.
13. 紀鳳蘭, 張建華. 銀離子敷料用于肛周膿腫切開術后的臨床效果觀察. 中國醫藥導報, 2010, 7(27): 34-35.
14. 趙永嬌, 何穎華, 智建文, 等. 中醫祛腐生肌法換藥促進肛周膿腫、肛瘺術后患者創面愈合的臨床觀察. 北京中醫藥, 2011, 30(3): 203-204.
15. Fleischmann W, Becker U, Bischoff M,et al. Vacuum sealing: indication, technique, and results. Eur J Orthop Surg Traumatol, 1995, 5(1): 37-40.
16. Chen SZ, Li J, Li XY,et al. Effects of vacuum-assisted closure on wound microcirculation: an experimental study. Asian J Surg, 2005, 28(3): 211-217.
17. 許龍順, 陳紹宗, 喬騁, 等. 負壓對創面血流量的影響. 第四軍醫大學報, 2000, 21(8): 976-978.
18. 李靖, 陳紹宗, 李學擁, 等. 封閉負壓引流對創面微循環超微結構影響的實驗研究. 中國美容整形外科雜志, 2006, 17(1): 75-77.
19. 胡祥, 喻愛喜, 俞國榮, 等. 負壓封閉引流對創面細胞黏附分子-1 表達及 IkBα 磷酸化的影響. 中華實驗外科雜志, 2012, 29(1): 123-125.
20. 呂小星, 陳紹宗, 李學擁, 等. 封閉負壓引流技術對創周組織水腫及血管通透性的影響. 中國臨床康復, 2003, 7(8): 1244-1245.
21. Squier CA. The effect of stretching on formation of myofibroblasts in mouse skin. Cell Tissue Res, 1981, 220(2): 325-335.
22. Takei T, Mills I, Arai K,et al. Molecular basis for tissue expansion: clinical implications for the surgeon. Plast Reconstr Surg, 1998, 102(1): 247-258.
23. Weed T, Ratliff C, Drake DB. Quantifying bacterial bioburden during negative pressure wound therapy: does the wound VAC enhance bacterial clearance? Ann Plast Surg, 2004, 52(3): 276-280.
24. Polykandriotis E, Kneser U, Kopp J,et al. Modified gloving technique for vacuum therapy in the hand. Zentrabl Chir, 2006, 131 Suppl 1: S36-S39.
25. Thompson G. An overview of negative pressure wound therapy (NPWT). Br J Community Nurs, 2008, 13(6): S23-S24, S26, S28-S30.
26. 王聲政, 魏金星, 張雪培, 等. 負壓封閉引流技術在 Fournier 壞疽中的應用. 中華外科雜志, 2013, 51(11): 1044-1045.
27. Murthi GV, Okoye BO, Spicer RD,et al. Perianal abscess in childhood. Pediatr Surg Int, 2002, 18(8): 689-691.
28. 方征宇, 潘志蕓, 李乾元, 等. VSD 在肛周膿腫術后創面應用的臨床觀察. 浙江臨床醫學, 2016, 18(6): 1071-1072.
29. 楊帆, 白祥軍. 負壓封閉引流 (VSD) 技術在各類創面的應用研究進展. 創傷外科雜志, 2011, 13(1): 82-84.

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The clinical effect of VSD technology in the treatment of high perianal abscess

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