高吸收伤口敷垫在急性坏死性胰腺炎清除术后伤口护理中的应用

Application of wound dressing pad with high absorbability in wound nursing after removal of acute necrotizing pancreatitis

目的分析高吸收伤口敷垫用于急性坏死性胰腺炎清除术后伤口护理中的价值。方法按照随机信封法将收治的急性胰腺炎清除术后伤口换药192例患者分为观察组与对照组各96例,对照组早期伤口消毒后应用常规无菌纱布外贴,观察组应用高吸收伤口敷垫(曼多夫)外贴,比较两组换药前、换药1周白细胞计数(WBC)、C反应蛋白(CRP)的变化,观察敷料及伤口恢复情况[敷料吸水性、敷料顺应性、伤口敷料揭除难易程度、切口疼痛评分、伤口周围皮肤情况、慢性伤口愈合评分(PUSH)、总换药次数、伤口愈合时间]及伤口皮肤相关并发症发生率。结果换药1周,观察组WBC、CRP低于对照组(P<0.05);换药3、4次观察组吸水性优于对照组(P<0.05),换药2、3、4次观察组敷料顺应性评分均高于对照组(P<0.05);观察组换药2、3、4次敷料揭除简单所占比例均高于对照组(P<0.05);换药3、4次,观察组疼痛评分、PUSH评分低于对照组(P<0.05),伤口周围皮肤评分高于对照组(P<0.05);观察组总换药次数少于对照组,伤口愈合时间短于对照组(P<0.05);观察组总伤口皮肤并发症发生率较对照组低(X^2=4.655,P<0.05)。结论高吸收伤口敷垫用于急性坏死性胰腺炎清除术后伤口保护较常规无菌纱布可促进炎症吸收,吸水性、顺应性强,换药难度低,可减少换药次数,促进伤口愈合,保护伤口周围皮肤,降低伤口皮肤相关并发症发生风险。

Objective To analyze the value of wound dressing pad with high absorbability in wound nursing after removal of acute necrotizing pancreatitis (ANP).Methods By using random envelope method,192 patients who underwent wound dressing change after removal of ANP were divided into observation or control group,96 in each group.After early wound disinfection,the control group was treated with external application of routine sterile gauze while the observation group was treated with wound dressing pad with high absorbability (Zetuvit E).Changes in white blood cell count (WBC) and C-reactive protein (CRP) before and after dressing change,condition of dressing,wound recovery such as water absorbency,compliance and removal complexity of dressing,incision pain score,skin condition around the wound,pressure ulcer scale for healing (PUSH) score,total frequency of dressing change and wound healing time as well as incidence of related complications were compared between the two groups.Results After 1 week of dressing change,WBC and CRP of the observation group were lower than those of the control group ( P <0.05).After 3 and 4 times of dressing change,water absorption of the observation group was better than that of the control group ( P <0.05).After 2,3 and 4 times of dressing change,compliance of dressing change scores of the observation group were higher than those of the control group ( P <0.05).Besides,the proportions of simple dressing removal in the observation group were higher than those in the control group ( P <0.05).After 3 and 4 times of dressing change,pain and PUSH scores of the observation group were lower than those of the control group ( P <0.05),and scores of skin around the wound were higher than those of the control group ( P <0.05).The total frequency of dressing change in the observation group was lower than that in the control group ( P <0.05),and wound healing time was shorter than that of the control group ( P <0.05).The total incidence of complications in the observation group was lower than that in the control group ( χ^2=4.655, P <0.05).Conclusion Compared with routine sterile gauze,wound dressing pad with high absorbability applied in wound protection after removal of ANP can promote the inflammation absorption.It has strong water absorption and compliance and no difficulty in dressing change.Besides,it can reduce the frequency of dressing change,promote the wound healing,protect the skin around the wound,and lower the risk of complications.