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目的：总结难愈性褥疮的治疗体会。方法褥疮 IV 期（深溃疡）患者40例，随机分为实验组和对照组。两组患者在手术前均进行支持治疗、清创及应用可调式负压吸引装置处理创面，待创面清洁、肉芽新鲜后行手术治疗封闭压疮创面。对照组19例（28侧），采用传统植皮术或皮瓣转移术，实验组21例（32侧），在清除死腔后利用皮肤牵张闭合器术中扩张牵引，减少创缘张力后一期缝合创面，术后持续使用牵张器2~3周。结果对照组平均住院时间（58.2±2.1）天，术后瘢痕明显有组织供区损伤。实验组平均住院时间（50.8±3.2）天，术后瘢痕不明显，无供区组织损伤，患者满意度高。与对照组相比，实验组住院时间明显缩短，差异有统计学意义（P ﹤0.05）。结论使用皮肤牵张闭合器联合可调式负压吸引装置治疗难愈性褥疮具有方法简单、结果可靠、创伤较小、并发症少等优点。“,”Objective To find a simple and valuable treatment method for chronic pressure ul-cer. Methods A total of 40 patients with chronic pressure ulcer were enrolled and they were randomly di-vided into control group and experiment group. Before the surgery,all the patients were treated by vacuum-assisted-closer system until the wound is clear. Skin-graft or flap-graft was used for 19 patients(28 sides) of control group and TopCloser was used for the 21 patients(32 sides)of experiment group. Results The mean hospital stay was(58. 2 ± 2. 1)days in the control group and(50. 8 ± 3. 2)days in the experi-ments(P ﹤ 0. 05). Conclusion The TopCloser and Vacuum-assisted-closer system is a new,simple, and valuable method for chronic pressure ulcer.