改良甲缘侧切整形术联合银离子藻酸盐敷料在踇趾嵌甲症中的应用效果研究

Study on the Application Effect of Modified Lateral Resection and Plastic Surgery of the Nail Margin Combined with Silver Ion Alginate Dressing on Ingrown Toenail

目的探讨改良甲缘侧切整形术后采用银离子藻酸盐敷料换药治疗踇趾嵌甲症的效果。方法选取2019年1月-2022年1月收治的踇趾嵌甲症95例,根据换药方案不同分为观察组48例和对照组47例,观察组采取改良甲缘侧切整形术联合银离子藻酸盐敷料换药,对照组采取改良甲缘侧切整形术联合传统纱布换药。比较2组术后康复指标、术后首次换药疼痛程度、手术前后Kolcaba舒适状况量表(GCQ)评分、术后感染发生率、预后指标及换药满意度。结果观察组术后创面干燥时间、红肿消退时间及伤口愈合时间均短于对照组,术后换药次数少于对照组,术后首次换药疼痛程度及术后感染发生率明显低于对照组,换药满意度明显高于对照组(P<0.05,P<0.01)。术后3、7 d,2组GCQ各维度评分较术前明显升高,术后3 d观察组GCQ各维度评分高于对照组(P<0.05,P<0.01)。2组治疗后畸形率、复发率比较差异无统计学意义(P>0.05)。结论改良甲缘侧切整形术后采用银离子藻酸盐敷料换药治疗踇趾嵌甲症,可发挥显著吸收能力与银离子抗菌作用的双重功效,达到促进伤口尽早愈合、减轻换药疼痛程度、降低感染风险、提高患者舒适度和满意度的目的。

Objective To investigate the effect of dressing change using silver ion alginate dressing after modified lateral resection and plastic surgery of the nail margin for ingrown toenail.Methods From January 2019 to January 2022,95 patients with ingrown toenail were selected and divided into observation group(n=48)and control group(n=47)according to different dressing plans.The observation group received modified lateral resection and plastic surgery of the nail margin combined with silver ion alginate dressing,while the control group received modified lateral resection and plastic surgery of the nail margin combined with traditional gauze dressing.Postoperative rehabilitation index,pain degree of first postoperative dressing change,Kolcaba General Comfort Questionnaire(GCQ)score before and after surgery,incidence of postoperative infection,prognostic index and dressing change satisfaction were compared between the two groups.Results The postoperative wound drying time,redness subside time and wound healing time in the observation group were shorter than those in the control group,the frequency of dressing change was less than that in the control group,the pain degree of dressing change and the incidence of postoperative infection were significantly lower than those in the control group,and the satisfaction degree of dressing change was significantly higher than that in the control group(P<0.05,P<0.01).At 3 and 7 d after surgery,scores of each dimension of GCQ in the two groups were significantly higher than those before surgery,and higher in the observation group than in the control group at 3 d after surgery(P<0.05,P<0.01).There was no significant difference in the rate of deformity and recurrence after treatment between the two groups(P>0.05).Conclusion After modified lateral resection and plastic surgery of the nail margin for ingrown toenail,silver ion alginate dressing for dressing change can play a dual role of significant absorption capacity and antibacterial effect of silver ion,so as to promote wound healing as soon as possible,reduce pain degree in dressing change and infection risk,and improve patient comfort and satisfaction.