负压封闭技术治疗难愈性创面的护理体会

Nursing experience of vacuum-assisted closure therapy in intractable wounds

目的探讨负压封闭引流技术在治疗难愈性创面过程中的护理工作及体会。方法采用负压封闭引流技术对84例难愈性创面患者进行治疗,在治疗期间护理工作主要包括:(1)观察负压封闭的粘贴是否完好,在改变体位后有无脱落漏气;(2)管道连接准确,各接头处有无密封不严的情况,管道是否堵塞,色泽是否变灰或黑色等;(3)吸引瓶内分泌物每日计量并做细菌培养等。结果本组因体位改变导致创面边缘贴膜脱落,皱褶漏气25例38处,补贴1次19例24处,补贴2次以上6例14处;负压吸引管堵塞5例,管道接头处堵塞3例;管道因变黑更换7例。上述问题护士均在第一时间发现并进行处理,必要时报告医师协助处理,使负压封闭治疗过程连续且按计划进行。结论负压封闭引流技术治疗难愈性创面,比传统创面换药治疗省时省力,缩短治疗时间,并且提高了创面愈合的成功率。

Objective To explore the nursing experience of vacuum- assisted closure （VAC） therapy in treating intractable wounds. Methods Eighty-four patients with intractable wounds were treated with VAC devices in our study. The key nursing points included ： （ 1 ） observing the intactness of the dressing and pressure tightness after changing positions; （2 ） making sure drainage tubes to be correctly connected,and checking whether drainage tubes were unblocked or turned grey or black, etc. ; （ 3 ） measuring secretion in suction bottle and performing bacteria culture daily. Results In our study, 38 sites in 25 patients were found leaking due to coating adjacent to wound margins wrinkled or shedded after changing positions ,24 sites in 19 patients re-pasted and 14 sites in 6 patients repasted twice or more;vacuum tubes were blocked in 5 cases,and tube junctions were blocked in 3 cases;blackened vacuum tubes were changed in 7 cases. The above issues were noticed and disposed by the nurses at the first time, who notified doctors if necessary and handled the case together to make sure therapy be performed steadily as planned. Conclusion Compared with traditional treatment,VAC therapy is a simple but effective treatment for intractable wounds and could shorten the treatment time and improve the wound healing rate.