“3P”疗法与传统清创换药修复开放性四肢骨折创面的比较

“3P” therapy versus traditional debridement therapy for open fractures of the extremities

背景:水动力清创系统联合银离子敷料和负压伤口治疗技术在治疗GustiloⅡ、Ⅲ型开放性四肢骨折中的疗效,简称"3P"疗法。目的:比较"3P"疗法与传统清创换药修复开放性四肢骨折创面的效果。方法:选择急诊就诊新疆医科大学第一附属医院开放性四肢骨折共30例,采用随机数字法分为采用"3P"疗法的试验组和传统清创换药的对照组。比较两组术后白细胞、超敏C-反应蛋白、细菌培养和药敏结果及疼痛程度。结果与结论:治疗后1,3,5,7 d对照组白细胞显著高于"3P"治疗的试验组。治疗后1,7 d对照组超敏C-反应蛋白显著高于试验组。细菌培养和药敏结果显示"3P"治疗可有效抑菌。"3P"治疗试验组治疗后7 d疼痛评分显著低于对照组(P<0.05)。结果表明水动力清创系统联合银离子敷料和负压伤口治疗技术在治疗GustiloⅡ、Ⅲ型开放性四肢骨折时可以有效的抗炎、抑菌并减少患者换药时产生的痛苦。

BACKGROUND： Versajet hydrosurgery system combined with silver ion dressings and negative pressure wound therapy in the treatment of Gustilo II and III open fractures of the extremities is known as ＂3P＂ therapy. OBJECTIVE： To explore the therapeutic effects of ＂3P＂ therapy versus traditional debridement therapy in the treatment of open fractures of the extremities. METHODS： Thirty patients with open fractures of the extremities admitted at the First Affiliated Hospital of Xinjiang Medical University, China were selected, and randomized into ＂3P＂ therapy group（test group） and traditional debridement therapy group（control group）. Counting of white blood cells, C-reactive protein, bacterial culture and drug sensitivity and the degree of pain were compared between two groups. RESULTS AND CONCLUSION： At 1, 3, 5, 7 days after treatment, the number of white blood cells in the test group was significantly lower than that in the control group. At 1 and 7 days after treatment, the expression of C-reactive protein was significantly higher in the control group than the test group. Results from bacterial culture and drug sensitivity tests showed that ＂3P＂ therapy could effectively inhibit bacterial growth. Pain score in the test group was significantly lower than that in the control group at 7 days after treatment（P 〈 0.05）. These findings indicate that Versajet hydrosurgery system combined with silver ion dressings and negative pressure wound therapy in the treatment of Gustilo II and III open fractures of the extremities can effectively fight against inflammation and bacterial growth, and reduce the pain of patients during dressing change.