负压封闭引流术治疗骨科开放伤伴创面感染的效果

Effect of Negative Pressure Closed Drainage for Open Orthopedic Wounds with Wound Infection

目的探讨负压封闭引流术(VSD)治疗骨科开放伤及创面感染的临床效果。方法选择2017年12月~2018年12月我院收治的84例骨科开放伤伴创面感染患者作为研究对象,随机分为VSD组和常规组,各42例。常规组清创、皮瓣修复后定期更换敷料,VSD组在此基础上行负压封闭引流术,比较两组临床疗效、创面面积、住院时间、Ⅱ期手术时间、换药次数、抗生素费用、住院费用及感染复发率。结果VSD组治疗总有效率为90.48%,高于常规组的61.90%,差异有统计学意义(P<0.05);VSD组创面面积、住院时间、Ⅱ期手术时间、换药次数、抗生素费用及住院费用均少于常规组,差异有统计学意义(P<0.05);VSD组感染复发率为2.38%,低于常规组的16.67%,差异有统计学意义(P<0.05)。结论VSD治疗骨科开放伤伴创面感染疗效确切,能够缩小创面面积、减少住院时间,降低抗生素使用量及换药次数,同时有助于控制感染,加快患者恢复。

Objective To investigate the clinical effect of negative pressure closed drainage(VSD)in the treatment of open orthopedic injuries and wound infections.Methods 84 orthopedic patients with open wounds and wound infections treated in our hospital from December 2017 to December 2018 were selected as the research subjects,and were randomly divided into the VSD group and the conventional group,with 42 cases in each group.In the conventional group,the dressing was changed regularly after the flap was repaired.The VSD group has ascending negative pressure closed drainage on this basis,the clinical efficacy,wound area,length of hospital stay,duration of stage II surgery,number of dressing changes,antibiotic costs,hospitalization costs,and infection recurrence rates were compared between the two groups.Results The total effective rate of treatment in the VSD group was 90.48%,which was higher than the conventional group's 61.90%,the difference was statistically significant(P<0.05);The wound area,length of hospital stay,stageⅡoperation time,number of dressing changes,antibiotic costs,and hospitalization costs in the VSD group were less than those in the conventional group,the differences were statistically significant(P<0.05).The recurrence rate of infection in the VSD group was 2.38%,which was lower than the 16.67%in the conventional group,the difference was statistically significant(P<0.05).Conclusion Negative pressure closed drainage is effective in treating orthopedic open wounds with wound infection,which can reduce the wound area,reduce the length of hospital stay,reduce the amount of antibiotics used and the number of dressing changes,and help control the infection and accelerate the recovery of patients.