不同敷料对老年骨折外固定患者切口感染的预防效果评价

Evaluation of prevention effectiveress on different dressings on incisional infection in elderly patients with external fixation of fracture

目的观察德莫林喷剂对行外固定架治疗的骨折患者创口感染的预防效果。方法选择2015年1月-2016年1月医院收治并进行外固定支架治疗116例患者为研究对象,随机平均分为两组,各58例,对照组予以常规处理,试验组予以德莫林喷剂,对比两组患者愈合情况、更换敷料频率及感染病原菌分布情况。结果试验组患者5d内每日更换敷料数明显低于对照组(P<0.05);试验组患者红肿发生率为13.79%,渗出发生率为12.07%,对照组红肿发生率为32.76%,渗出发生率为34.48%,两组患者红肿及渗出发生率差异有统计学意义(P<0.05);试验组术后7d和14d针孔感染率分别为3.79%和9.20%,对照组术后7d和14d针孔感染率分别为17.49%和28.71%,差异有统计学意义(P<0.05);第14天对两组已感染患者进行细菌培养,试验组7例发生感染,感染率为12.07%,对照组16例发生感染,感染率为27.59%,两组患者感染率比较差异有统计学意义(χ~2=4.3927,P<0.05),试验组感染患者分离出8株病原菌,对照组患者分离出19株病原菌,金黄色葡萄球菌在两组患者分离菌中构成比均最高,分别占50.00%、42.11%。结论德莫林喷剂能有效防止外固定支架术后患者针孔感染,感染病原菌以金黄色葡萄球菌为主。

OBJECTIVE To observe the preventive effect of Demolin spray on incisional infection in patients with fracture treated with external fixator.METHODS A total of 116 patients treated with external fixator from Jan.2015 to Jan.2016 were selected as research objects,and were randomly divided into two groups,with 58 cases in each group.Patients in control group received conventional treatment,and patients in experimental group received Demolin spray.The healing rate,the dressing frequency and the pathogen infection of the two groups were compared.RESULTS The number of daily dressings in experimental group was significantly lower than that in control group（P〈0.05）.The incidence of sured and swollen and exudation of experimental group were 13.79% and12.07%,which were 32.76%and 34.48% of control group,and the differences were statistically significant（P〈0.05）.7days and 14 days after operation,the pinhole infection rates of experimental group was 3.79% and9.20%,the pinhole infection rates of control group were 17.49% and 28.71%,and the difference was statistically significant（P〈0.05）.On the 14 th day,two groups of infected patients were subjected to bacterial culture,there were 7cases of infection in experimental group,and 16 cases of infection in control group,with the infection rates of 12.07% and 27.59%.The infection rates in the two groups was statistically different（χ2=4.3927,P〈0.05）.Eight strains of pathogenic bacteria were isolated from experimental group and 19 strains were isolated from control group.Staphylococcus aureus had the highest proportion in the isolated bacteria of the two groups,accounting for 50.00% and 42.11%.CONCLUSION Dermolin spray can effectively prevent postoperative external fixation stent in patients with pinhole infection,and S.aureus is the main cause of infection of pathogens.