负压封闭引流治疗耐甲氧西林金黄色葡萄球菌感染性皮肤脓肿的效果观察

Therapeutic effect of vacuum sealing drainage in the treatment of methicillin-resistant Staphylococcus aureus infected skin abscess

目的探讨临床应用负压封闭引流治疗耐甲氧西林金黄色葡萄球菌感染性皮肤脓肿的效果。方法选择2017年1月至2019年12月青岛市胶州中心医院烧伤整形科收治的耐甲氧西林金黄色葡萄球菌感染性皮肤脓肿病例,按照随机数字表法将患者随机分为对照组与试验组。对照组采用凡士林油纱填塞引流换药方案进行治疗,试验组采用负压封闭引流换药方案进行治疗。治疗过程中对比观察2组皮肤脓肿腔隙闭合情况,并定期行脓液细菌培养及抗菌药物敏感试验检测,观察创面感染控制情况。结果共纳入68例耐甲氧西林金黄色葡萄球菌感染性皮肤脓肿患者,男43例,女25例,年龄(47.66±15.71)岁。对照组34例,男20例,女14例,年龄(46.96±16.23)岁;试验组34例,男23例,女11例,年龄(48.35±15.18)岁。皮肤脓肿腔隙闭合时间,对照组为(27.79±1.97)d,试验组为(15.74±1.31)d;脓液细菌培养及药敏试验检测由耐甲氧西林金黄色葡萄球菌至无致病性细菌生长的时间,对照组为(18.65±1.47)d,试验组为(9.76±1.28)d,2组比较差异有统计学意义(P<0.05)。结论耐甲氧西林金黄色葡萄球菌感染性皮肤脓肿切开清创,应用负压封闭引流换药治疗,通过主动充分引流脓液,改变致病性细菌繁殖生长微环境,促进腔隙内新鲜肉芽组织生长,可更有效控制耐甲氧西林金黄色葡萄球菌感染,促进皮肤脓肿腔隙闭合,缩短临床治疗周期。

Objective To explore the clinical application of vacuum sealing drainage(VSD)in the treatment of skin abscess caused by methicillin-resistant staphylococcus aureus(MRSA)infection.Methods From January 2017 to December 2019,patients with skin abscess caused by MRSA admitted to the Department of Burns and Plastic Surgery of Qingdao Jiaozhou Central Hospital were selected.The patients were randomly divided into control group and experimental group according to the random number table method.Control group was treated with vaseline gauze packing,drainage and dressing change.Experimental group was treated with VSD and dressing change.During the treatment,the lacunar closure of skin abscess in the two groups was observed comparatively,pus bacteria culture and antibiotic sensitivity test were conducted regularly to observe the wound infection control situation.Results A total of 68 patients with skin abscess caused by MRSA were enrolled,including 43 males and 25 females,the average age was 47.66±15.71 years old.There were 20 males and 14 females in the control group(mean age 46.96±16.23 years old),23 males and 11 females in the experimental group(mean age 48.35±15.18 years old).The healing time of skin abscess lacuna in control group was(27.79±1.97)d,(15.74±1.31)din experimental group.Bacterial culture of pus and drug sensitivity test detect the growth time from MRSA to non-pathogenic bacteria in control group was(18.65±1.47)d,(9.76±1.28)din experimental group.The difference between the two groups was statistically significant(P<0.05).Conclusions After incision and debridement,VSD and drainageand dressing change may serve as an alternative option for the skin abscess infected by MRSA.By actively and fully draining pus,the microenvironment of pathogenic bacteria reproduction and growth is changed,and the growth of fresh granulation tissue in the lacuna is promoted,the infection of MRSA can be more effectively controlled,the lacuna closure of skin abscess is promoted,and the clinical treatment cycle is shortened.