负压封闭引流负压值对体表感染创面愈合的影响

Effect of negative pressure profile of vacuum sealing drainage on infected wound surface

目的探讨负压封闭引流负压值的大小对治疗体表感染创面愈合的效果。方法选择体表感染创面患者90例,按随机数字表法分为3组,每组30例。分别应用-16kPa、-50kPa、-70kPa3个不同的负压值,观察各组负压引流后3～5d平均创面引流量、体温、创缘皮温及观察创面治疗期间换引流物次数、创面清洁时间、愈合时间、并发症。通过两两比较,进行对比分析。结果3个不同负压组平均创面引流量经方差分析,F=26.983,P<0.01,有显著性差异,再经两两比较LSD法,-16kPa组分别与-50kPa、-70kPa组比较有显著性差异(P均<0.01);-50kPa与-70kPa组之间无显著性差异。-50kPa与-70kPa组引流效果较好,体温、创缘皮温3组之间无显著性差异。换引流物次数、创面清洁时间、愈合时间3组都有显著性差异(P<0.01),并发症发生率无显著性差异。结论负压封闭引流治疗体表感染创面应用-70kPa压力有效地减少创面引流量、换引流物次数、创面清洁时间,缩短愈合时间,并发症发生较少,-70kPa为较佳负压值。

Objective To investigate the effect of vacuum sealing drainage (VSD) at varied negative pressures on the infected wound surface. Methods Ninety patients with infected wound surface were randomized evenly into three groups,treated with -16 kPa,-50 kPa and -70 kPa negative pressures respectively. The average draining volume,body temperature,skin temperature at the edge of wounds 3~5 days since drainage,times for changing VSD pads,span for cleaning the wounds,time of healing as well complications were observed and compared between the groups. Results There was significant difference in terms of draining volume(F=26.983,P<001). Variance analysis showed significant differences between -16 kPa group and -50 kPa group,-70 kPa group(all P<0.1). However,there was no significant difference between the three groups in terms of body temperature and skin temperature at the edge of wounds. On the other hand,the differences were significant between the three groups in view of times for changing VSD pads,span for cleaning the wounds and time of healing (P<0.01) except complications. Conclusion Use of 70kPa negative pressure in drainage is effective to reduce the draining volume at the wound surface,VSD pads,shorten span for cleaning the wounds and time of healing and reduce the complications.