负压封闭引流与换药治疗压疮感染创面疗效观察

Clinical observation of technology of VSD and traditional dressing change applied in treatment of infected wounds of pressure sores

目的观察采用负压封闭引流与传统换药治疗压疮感染创面的换药次数以及行Ⅱ期手术的时间。方法选择2009年5月-2013年5月医院发生Ⅲ及Ⅳ度压疮患者94例,随机分为负压组与传统组,每组各47例,经过对创面的严格清创和消毒后,负压组给予负压封闭引流,传统组每天给予换药,两组患者均配合相应抗菌药物进行治疗,并择期行Ⅱ期修复手术。结果负压组平均换药次数为(2.1±0.5)次,传统组为(27.8±6.3)次,负压组的换药次数明显少于传统组,差异有统计学意义(t=21.976,P<0.05);负压组行Ⅱ期手术的平均围手术时间为(20.4±4.7)d,传统组为(29.6±8.1)d,负压组所需时间明显短于传统组,差异有统计学意义(t=15.742,P<0.05);两组患者压疮均治愈,无1例发生死亡。结论采用负压封闭引流治疗压疮感染较传统换药能明显提高创面愈合速度,减少患者住院天数,降低治疗费用,患者所受痛苦小,值得临床推广。

OBJECTIVE To observe the times of dressing changes and II stage operative time of technology of VSD and traditional dressing change applied in treatment of infected wounds of pressure sores. METHODS A total of 94 cases of patients in pressure sores of III or IV degrees in our hospital from May 2009 to May 2013 were selected and divided randomly into VSD group （47 cases） and tradition group （47 cases）. After strict debridement and disinfection to the wounds, VSD was given in VSD group, while daily dressing change was given in tradition group. Appropriate antibiotic was given in both groups, and II stage repair surgery should be given when necessary. RESULTS The mean number of dressing change in VSD group was （2.1±0.5）, while （27.8±6.3） in tradition group, which was obviously higher than VSD group and the difference was statistically significant （t = 21. 976, P〈0.05）. The mean time before II stage repair surgery was （20.4±4.7） days in VSD group, while （29.6± 8. 1） days in tradition group, in which was obviously higher than VSD group and the difference was significant （t=15. 742, P〈0. 05,）. All the pressure sores was cured in both groups, and nobody was dead. CONCLUSION The healing speed of wound is significantly increased by VSD comparing with traditional dressing change. It deserves the clinical expansion as which could shorten the days of hospitalization, reduce treatment costs, and alleviate pain.