闭式灌洗引流术治疗手部感染的治疗体会

Experience of closed lavage drainage for the treatment of hand infections

目的：评价采用闭式灌洗引流术治疗手部感染性创口的效果。方法2011年1月至2013年12月，对吉林大学第一医院手足外科收治的57例各种原因引起的手部感染性伤口应用闭式灌洗引流术进行治疗。观察术后灌洗液的性状，创口有无炎症反应，瘢痕增生，组织粘连。结果57例患者中，53例患者伤口一期愈合，其中33例出现轻微红肿及炎症反应，20例患者未出现炎症反应。4例患者因伤口部位皮瓣部分坏死，导致伤口未愈合，二期行植皮治疗伤口愈合。随访3～12个月，35例无明显组织粘连及瘢痕增生，22例伴有不同程度组织粘连及瘢痕增生。结论应用闭式灌洗引流治疗手部感染性伤口，可以达到一期闭合伤口，保护深层的肌腱、神经、血管及骨骼组织。

Objective To evaluate the effectivity of using closed lavage drainage for the treatment of hand infective wounds.Methods From January 2011 to December 2013,57 patients with hand infective wounds in department of hand and podiatry,the First Hospital of Jilin University were treated by using the closed lavage drainage.The reasons of these wounds were various,including blast injury,chainsaw injury, strangulation injuries,bites,etc.Postoperative lavage fluid property,wound presence of inflammation,scar hyperplasia and the presence of tissue adhesion were observed.Results Of the 57 patients,53 wounds were primary healed,of which 33 wounds had mild inflammation and other 20 wounds presented no inflammation. Four wounds were secondary healed with the process of skin transplantation due to the partial necrosis of the flap.Followed up for 3 to 12 months,35 wounds had no obvious tissue adhesion and scar hyperplasia, 22 wounds presented different degree of tissue adhesions and scar hyperplasia.Conclusions Using closed lavage drainage to treat the hand infective wound could achieve primary healing,and therefore protect the subcutaneous tissue,such as tendons,nerves,vessels and bones.