溃疡油联合纳米银治疗心脏术后伤口不愈合4例报道

A report on four cases with non-healing wounds caused by postcardiac surgery treated by the combination of ulcer oil and nano-silver

心脏术后胸壁和下肢血管供区伤口感染、裂开、血肿、延迟愈合等并发症发生率高,其治疗方法局限、伤口愈合难度大,是临床面临的棘手问题。将溃疡油联合纳米银用于治疗心脏术后伤口不愈合,发现其具有加速伤口愈合的作用。本文报道2018—2020年于中日友好医院住院治疗的4例典型病例(男3例,女1例),均行开胸心脏手术,术后1个月伤口仍未愈合。主要表现为伤口裂开、创缘坏死、硬痂形成、伤口内组织失活、胸骨开裂、脓液积聚。2例伴有鲍曼不动杆菌定植,3例存在胸壁伤口不愈合,2例存在下肢血管供区伤口不愈合,1例胸骨裂开且内固定物松动。伤口治疗均采用清创术后溃疡油联合纳米银外敷,隔日换药1次。4例伤口分别于65、45、40、65 d后愈合,平均愈合时间为53.75±13.15 d。溃疡油联合纳米银可加速心脏术后延迟愈合伤口的愈合进程,其主要适用于胸骨表面浅表伤口和El OakleyⅠ型和Ⅱa型伤口、下肢血管供区伤口。

The complications of postcardiac surgery such as wound infection,cracking,hematoma and delayed union,etc.The chest wall and lower limb blood vessel donor sites have high incidence rates,limited therapeutic methods and high difficulty in wound healing,and they are clinical problematic issues.Ulcer oil and nano-silver were used to treat the wound cracking of postcardiac surgery and found that the combination could accelerate the wound healing.The four clinical cases reported in this paper had been treated in hospitalization of China-Japan Friendship Hospital during the period from 2018 to 2020(three males and one female),who had been performed open chest surgery,but their wounds had not been healed for one month after the surgery.The main expressions were wound dehiscence,wound edge necrosis,formation of hard scab,inactivation of wound internal tissue,sternum cracking and fester accumulation.Two cases were also with Acinetobacter baumanii planting;three cases were with the non-healing wounds of chest wall,two cases were with non-healing wounds of lower limb blood vessel donor site,one case was with sternum cracking of sternum,and the internal fixator was loosen.The wound was treated with the external application of ulcer oil combined with nano-silver after debridement surgery,and the dressings were changed every other day.The four cases’wounds were healed on 65,45,40 and 65 days later,with the average healing time of 53.75 days.The combination of ulcer Oil and nano-silver could accelerate the healing progress of the delayed healing of wounds caused by postcardiac surgery.It is mainly applicable for superficial wounds of sternum surface and wounds of El OakleyⅠType andⅡa Type and wounds in lower limbs blood vessel donor site.