两种自溶性清创法在伤及皮下组织伤口中的应用效果

Clinical Effects of Two Different Autolytic Debridement on Subcutaneous Wounds

目的评价两种自溶性清创方法在伤及皮下组织清创期的效果。方法将2015年1月-12月接诊的38例表面黄期伤及皮下组织的患者按就诊顺序编号,并随机分为对照组及试验组,每组各19例。对照组采用无定形水凝胶进行自溶性清创,试验组则在对照组的基础上加用藻酸盐进行处理。比较两组创面清创时间、换药次数、肉芽生长情况、清创结束时伤口面积缩小率、渗液渗漏发生情况。结果试验组和对照组清创时间分别为(21.11±5.86)、(26.69±9.68)d,换药次数分别为(7.21±2.12)、(9.37±3.32)次,肉芽生长评分分别为(2.58±0.61)、(1.95±0.71)分,清创结束时伤口面积缩小率分别为(47.00±26.24)%、(29.03±22.62)%,渗液渗漏发生率分别为0.0%、3.3%,以上指标组间差异均有统计学意义(P<0.05)。结论自溶性清创时,无定形水凝胶配合藻酸盐类敷料比单纯使用清创效果更佳,渗漏发生更少。

Objective To evaluate the effects of two different autolytic debridment on subcutaneous wounds. Methods Thirty-eight patients with subcutaneous wounds treated from lanuary to December 2015 were numbered according to the sequence of admission, and were randomly divided into trial group and control group, with 19 patients in each group. All the patients had yellow surface. Patients in the control group were treated with amorphous hydrogel, while those in the trial group were treated with both amorphous hydrogel and alginate dressing. Then, we compared the two groups in terms of the debridement time, frequency of changing dressing, granulation growth, wound contraction rate at the end of debridement period, and leakage rate. Results The debridement time in the trial group was （21.11±5.86） days, and it was significantly shorter than that in the control group [（26.69±9.68） days] （P 〈 0.05）; the frequency of changing dressing was （7.21±2.12） times, which was less than that in the control group [（9.37±3.32） times] （P 〈 0.05）; and granulation growth was better than that in the control group （2.58±0.61 vs. 1.95±0.71, P 〈 0.05）. The wound contraction rate at the end of debridement period in the trial group was （47.00±26.24）%, which was higher than that in the control group [（29.03±22.62）%] （P 〈 0.05）; and the leakage rate （0.0%） was lower than the control group （3.3%） （P 〈 0.05）. Conclusion Using amorphous hydrogel and alginate dressing for subcutaneous wounds is better than amorphous hydrogel alone for autolytic debridement, and can lower the leakage rate.