一期缝合联合银敷料治疗犬咬伤临床研究

Clinical Eficacy of Primary Suture Combined with Silver Dressing in the Management of Bite Wounds

目的探讨一期缝合联合银敷料(优拓S.S.D)与传统方法对犬咬伤Ⅲ级创面的治疗效果。方法将35例患者38处不同部位犬咬伤Ⅲ级创面按就诊顺序随机分为两组。观察组对创面常规清创后一期缝合,并放置银敷料引流条。对照组局部使用1‰雷弗奴尔、0.5%甲硝唑、阿托品合成溶液湿敷换药。分别于治疗2周、4周后观察创面愈合情况,并比较两组换药次数、愈合时间、换药费用及疼痛评分。结果治疗2周及4周后观察组总有效率均明显高于对照组,差异有统计学意义(P<0.05);观察组较对照组换药次数明显减少,愈合时间明显缩短,换药费用明显降低,差异均有统计学意义(P<0.05);观察组患者在去除敷料、清洗伤口、敷料应用及固定后的疼痛评分均明显低于对照组,差异有统计学意义(P<0.05)。结论一期缝合联合银敷料治疗犬咬伤Ⅲ级创面能够加速创面愈合,降低医疗费用,减轻患者疼痛,提高治愈率。

Objective To investigate the clinical efficacy of primary suture combined with silver dressing（Urgotul S.S.D）in the management of grade Ⅲ bite wounds.Methods A total of 35 patients with grade Ⅲ bite wounds at 38 sites were divided into two groups：observation group,in which patients received silver dressing on their wounds,followed by primary suture after debridement;and control group,in which patients were treated with 1‰ rivanol,0.5% metronidazole,and atropine dressing.The wounds were observed 2 and 4 weeks after treatment.The dressing change frequencies,days needed for wound healing,treatment cost,and pain scores in these two groups were compared.Results The total effective rate was significantly higher in the observation group than in the control group（P〈0.05）.The dressing change frequency,wound healing time,and treatment cost in observation group were significantly lower than those in the control group（P〈0.05）.Pain scores when taking away dressing,cleaning the wounds,applying dressing to the wounds,and after bandaging in the observation group were all significantly lower than those in control group（P〈0.05）.Conclusion Primary suture combined with silver dressing shows many advantages in treating grade Ⅲ bite wounds in terms of effectiveness,cost,painful feeling,and cure rate.