伤口床准备贯序处置方案在胫腓骨开放性骨折术后创面不愈合中的应用

The application of wound-bed preparation sequential plan in the treatment of postsurgical unhealed wound following tibiofibula open fracture

目的探索伤口床准备贯序处置方案在胫腓骨开放性骨折术后对创面愈合的有效性。方法选取海军总医院2011年5月至2014年5月收治的胫腓骨开放性骨折术后不愈合患者46例,经患者知情同意分为2组。伤口床准备贯序处置组23例,对照组23例。评价指标:伤口创面改善情况、创面总体愈合时间、标准化创面愈合时间。结果伤口床贯序处置组出现新鲜肉芽组织平均天数(4.30±1.49)d,少于传统换药组(6.00±2.31)d,差异有统计学意义(P=0.001);贯序处置组总体愈合时间、标准化创面愈合时间分别为(36.00±12.74)d、(2.01±0.69)d/cm3,传统换药组为(51.70±16.45)d、(2.60±1.03)d/cm3,2组比较差异有统计学意义(P=0.001、0.027)。结论伤口床准备贯序处置方案用于治疗胫腓骨开放性骨折术后不愈合创面,有助于改善伤口床情况,促进肉芽新生,加速创面愈合。

Objective To explore the effect of wound-bed preparation sequential plan on wound healing following tibiofibula open fracture. Methods Forty-six patients with postsurgical unsealed wound following tibiofibula open fracture,who were admitted into the Navy General Hospital from May 2011 to May 2014 were selected for our study. With the knowledge and consent of the patients,the patients were randomly divided into 2 groups： the wound-bed preparation sequential plan group（ or simply the sequential plan group）（ n = 23） and the control group（ n = 23）. Evaluation indicators included： improvement of wound surface,total time of wound surface healing and standard wound surface healing time. Results No. of days when fresh granulation appeared for the sequential plan group were（ 4. 30 ± 1. 49） d,which were shorter than those of the routine treatment group（ 6. 00 ± 2. 31） d,with statistical significance（ P = 0. 001）. Total time of wound surface healing and standard wound surface healing time for the sequential plan group were respectively（ 36. 00 ± 12. 74） d and（ 2. 01 ± 0. 69） d / cm^3. However,for the routine treatment group,total time of wound surface healing and standard wound surface healing time were respectively（ 51. 70 ± 16. 45） d and（ 2. 60 ± 1. 03） d / cm^3,and statistical significance could be noted,when comparisons were made between the 2 groups（ P = 0. 001,0. 027）. Conclusion When used in the treatment of postsurgical unsealed wound following tibiofibula open fracture,the standard wound-bed preparation sequential plan was beneficial to the improvement of wound bed,enhancement of granulation and acceleration of wound healing.