持续负压封闭引流在急诊四肢Ⅱ类手术创面中的临床应用研究

Clinical application and research of vacuum sealing drainage on wound of limbs trauma during emergency typeⅡ operation

目的探讨负压封闭引流技术(vacuum sealing drainage,VSD)在急诊四肢Ⅱ类手术创面中的临床应用。方法回顾性分析VSD组38例,采用VSD治疗,对照组34例,采用常规手术及引流方法治疗。观察患者伤口分泌物细菌培养阳性率、脓毒症发生率、行植皮或皮瓣转移手术率、换药次数、伤口愈合时间、伤口愈合等级(甲级/乙级/丙级)比率、住院天数以及治疗总费用(不含内置物)等。结果两组患者换药次数、伤口愈合时间、住院天数以及不含内置物的治疗总费用四个计量指标在VSD组均明显低于未应用VSD的对照组(P<0.05),患者伤口分泌物细菌培养阳性率、脓毒症发生率在VSD组均明显低于未应用VSD的对照组(P<0.05),伤口愈合等级(甲级/乙级/丙级)比率VSD组也明显优于未应用VSD的对照组(P<0.05)。结论在处理四肢Ⅱ类手术创面时,早期、急诊应用VSD具有吸附坏死组织和创面渗出物、持续创面主动引流和预防感染等作用,可有效降低患者术后脓毒症的发生率,缩短住院时间,减轻经济负担。

Objective To investigate the clinical application of treatment for operation of emergency extremities typeⅡwounds by vacuum sealing drainage(VSD).Methods Through retrospective study,thirty-eight patients were allocated in study group(n=38),in which patients were treated by VSD,and control group(n=18),in which patients were treated by normal drainage according to the traditional method.The indexes were investigated which included the infection rate in wound secretion,incidence of sepsis,the proportion of skin grafting operation,times of dressing change,wound healing time,grades of wound healing,post-operative hospitalization days and treatment total cost apart from the expend of built-in things.Results Times of dressing change,wound healing time and post-operative hospitalization days and treatment total cost apart from the expend of built-in things in group treated by VSD were significantly lower than that in control group(P<0.05).The infection rate in wound secretion,incidence of sepsis was also lower than that in control group(P<0.05),and the grades of wound healing was significantly higher in group treated by VSD as compared with that in control group(P<0.05).Conclusions The emergency treatment of VSD can suck the exudate of the necrotic tissues and the wounds,maintain draining wounds and prevent infection.VSD can reduce the incidence of sepsis effectively,shorten the hospitalization time,and decrease the cost effectively.