封闭式负压引流技术对手外伤感染患者创面修复效果及二次手术率的影响

Effect of vacuum sealing drainage on wound repair effect and secondary operation rate in patients with hand injury and infection

目的探讨封闭式负压引流技术(vacuum sealing drainage,VSD)对手外伤感染患者创面修复效果及二次手术率的影响。方法选取2020年1月至2022年8月景德镇市第三人民医院收治的60例手外伤感染患者作为研究对象,随机分为研究组与参照组,每组30例。研究组采用VSD处理,参照组采用常规换药处理。比较两组感染创面修复优良率、创面引流量、换药次数、创面痊愈所用时间、总治疗时间、炎症因子[C反应蛋白(C-reactive protein,CRP)、白细胞介素-8(interleukin-8,IL-8)、WBC]、视觉模拟评分法(visual analogue scale,VAS)评分及二次手术率、并发症发生率。结果研究组感染创面修复优良率高于参照组,差异有统计学意义(P<0.05)。治疗后5、7 d,两组创面引流量均少于治疗前,但治疗后3、5、7 d,研究组创面引流量均多于参照组,差异有统计学意义(P<0.05)。研究组换药次数少于参照组,创面痊愈所用时间、总治疗时间均短于参照组,差异有统计学意义(P<0.05)。术后,两组CRP、IL-8、WBC水平均低于术前,且研究组低于参照组,差异有统计学意义(P<0.05)。治疗后5、7 d,两组VAS评分均低于治疗前,且治疗后3、5、7 d,研究组VAS评分均低于参照组,差异有统计学意义(P<0.05)。研究组并发症发生率及二次手术率均低于参照组,差异有统计学意义(P<0.05)。结论VSD应用于手外伤感染患者创面修复中,能下调炎症因子表达,促使创面快速愈合,减轻痛感,减少并发症,缩短治疗时间,降低二次手术率,值得临床推广应用。

Objective To investigate the effect of vacuum sealing drainage(VSD)on wound repair effect and secondary operation rate in patients with hand injury and infection.Methods 60 patients with hand injury and infection admitted to the Third People's Hospital of Jingdezhen from January 2020 to August 2022 were selected as the study subjects,and they were randomly divided into the study group and the reference group,with 30 cases in each group.The study group was treated with VSD,and the reference group was treated with conventional dressing change.The excellent rate of wound repair,wound drainage volume,dressing change times,time of wound healing,total treatment time,inflammatory factors(C-reactive protein[CRP],interleukin-8[IL-8],WBC),visual analogue score(VAS),secondary operation rate,and incidence of complications were compared between the two groups.Results The excellent rate of wound repair in the study group was higher than that in the reference group,and the difference was statistically significant(P<0.05).At 5 and 7 d after treatment,the wound drainage volume of the two groups were less than those before treatment,but at 3,5 and 7 d after treatment,the wound drainage volume in the study group was more than that in the reference group,and the differences were statistically significant(P<0.05).The number of dressing changes in the study group was less than that in the reference group,and the wound healing timeand total treatment time were shorter than those in the reference group,and the difference was statistically significant(P<0.05).After operation,the levels of CRP,IL-8 and WBC of the two groups were lower than those before operation,and the study group was lower than the reference group,and the differences were statistically significant(P<0.05).At 5 and 7 d after treatment,the VAS scores of the two groups were lower than those before treatment,and at 3,5 and 7 d after treatment,the VAS scores in the study group were lower than those in the reference group,and the differences were statistically significant(P<0.05).The incidence of complications and second operation ratein the study group were lower than those in the control group,and the differences were statistically significant(P<0.05).Conclusion VSD can reduce the expression of inflammatory factors,promote rapid wound healing,reduce pain,reduce complications,shorten treatment time,and reduce the rate of secondary operation in patients with hand injury and infection,which is worthy of clinical application and promotion.