负压伤口治疗时两种填充敷料对伤口床温度和渗液酸碱度的影响

Effects of Wound Bed Temperature and pH in Chronic Wounds Treated by Negative Pressure Wound Therapy with Two Types of Filling Dressings

目的比较实施负压治疗时纱布和泡沫填充敷料对伤口床温度(伤口温度和伤口周围皮肤温度)和渗液酸碱度的影响,以筛选更合理有效的填充敷料。方法便利抽样法选择2009年10月至2011年3月在南京军区南京总医院门诊伤口护理中心治疗的20例患者为研究对象,按入院时间的先后将其分为A、B两组,每组10例。A组患者采用泡沫敷料,B组患者采用纱布作为填充敷料实施负压治疗,两组患者均给予智能化吸引装置,其压力值和吸引模式均相同。两组在治疗前及治疗后7、14、21d使用相同方法测量伤口床温度及渗液pH,并比较两组患者治疗3周后的平均伤口缩小率、治愈率及愈合时间。结果敷料干预主效应、敷料干预与治疗时间交互效应,两种填充敷料实施负压治疗前和后21d内渗液pH变化、伤口温度和周围皮肤温度差异均无统计学意义(均P>0.05);治疗时间主效应、负压治疗前和后21d内渗液pH差异均无统计学意义(均P>0.05),但伤口温度随治疗时间延长有明显升高(P<0.05)。结论纱布和泡沫敷料作为填充敷料实施负压伤口治疗对伤口床温度及渗液pH作用相当,均可以作为负压治疗的有效敷料。

Objective To compare the temperature of the wound bed （the wound and area around the wound）, and pH in chronic wounds treated by negative pressure wound therapy with gauze and foam as filling dressings so as to get more effective dressings. Methods Twenty patients were enrolled into this study by convenience sampling method in Outpatient of Wound Center,Nanjing PLA General Hospital of Nanjing Command from October 2009 to March 2011. Cases were equally divided into group A and B according to the time they entered the hospital. Group A used negative pressure wound therapy with foam and group B with gauze. Suction pump, pressure value and suction model of the two groups were all the same. Temperature of the wound bed and exudates pH were measured with the same ways at vacuum assisted closure therapy at 0,7,14 and 21th day. The wound decreased rate, cure rate and mean healing time were compared between the two groups after 3--week treatment. Results With dressings main effect,and interaction effect between dressings and treating time,there was no significant difference in the wound bed temperature and exu- dates pH before and 21days after treating between the two groups （P^0. 05）. With treating time interaction effect, there was no significant difference in the exudates pH before and 21days after treating between the two groups（P~ 0. 05） ,but the wound temperature was significantly rised （P^0. 05）. Conclusion Negative pressure wound therapy with gauze and foam as filling dressings have similar effects for wound bed temperature and exudates pH. They are beneficial to use as effective filling dressings for negative pressure wound therapy.