肝素溶液持续湿敷对头颈部创口Ⅰ期愈合及初期瘢痕形成的影响

Effects of continuous wet compress of heparin solution on first intention and initial scar of head and neck incisionse

目的探讨肝素溶液持续湿敷对头颈部创口Ⅰ期愈合及初期瘢痕形成的影响。方法根据纳入排除标准,收集2020年8月—2022年2月在海南省肿瘤医院头颈外科接受头颈部手术的患者共60例。由于我科在2021年8月以前未开展头颈部术后肝素湿敷治疗,因此在此时间节点之前的患者均纳入对照组(n=30),而在此之后收治的患者均接受了术后肝素湿敷治疗,被纳入干预组(n=30)。对照组每日常规换药,干预组予以肝素溶液持续湿敷。观察并记录Ⅰ期愈合率、术区感染情况、患者与观察者瘢痕评估量表(POSAS)、温哥华瘢痕量表(VSS)、患者满意度等指标。初步评价术后肝素溶液持续湿敷对创口Ⅰ期愈合及初期瘢痕形成的影响。结果较常规术后换药,肝素溶液持续湿敷能促进创口Ⅰ期愈合、降低感染风险,组间差异有统计学意义(P<0.05);干预组疗效好,无效率显著低于对照组(P<0.01);干预组POSAS、VSS评分均低于对照组,差异有统计学意义(P<0.05)。结论相较于常规术后换药,肝素溶液持续湿敷能促进创口I期愈合,减轻创口炎症反应、降低创口感染风险、干预创口初期瘢痕形成,此操作具有操作简便,疗效显著、经济、副作用少等优点,值得临床推广应用。

Objective To investigate the effects of continuous wet compress of heparin solution on primary healing of head and neck wounds and initial scarring of wounds.Methods According to the inclusion-exclusion criteria,a total of 60 patients who underwent head and neck surgery in the Affiliated Cancer Hospital of Hainan Province from August 2020 to February 2022 was screened.Since heparin wet compress therapy after head and neck surgery was not carried out in this hospital before August 2021,the patients before this time point were included in the control group(n=30),and the patients after this time with postoperative heparin wet compress application was included in the intervention group(n=30).In control group,the dressing was changed daily and in the intervention group,heparin solution was applied as a continuous wet dressing on top of the intervention group.The healing rate at stage I,infection in the surgical area,Patient and Observer Scar Assessment Scale(POSAS),Vancouver Scar Scale(VSS)and patient satisfaction were observed and recorded.Preliminary evaluation of the effect of continuous wet dressing with postoperative heparin solution on primary healing and initial scar formation.Results Compared with routine postoperative dressing change,continuous wet compress of heparin solution promoted primary wound healing and reduce the risk of infection.The curative effect of the intervention group was good,and the inefficiency was significantly lower than that in the control group.The POSAS and VSS scores of the intervention group were lower than those in the control group.Conclusion Compared with conventional postoperative dressing change,continuous wet application of heparin solution could promote wound healing,reduce wound inflammation,decrease the risk of wound infection and reduce wound scar.This method has the advantages of simple operation,obvious efficacy,economy and few side effects,and is worthy of clinical application.