手型与传统负压封闭引流技术治疗手部软组织缺损伤的疗效比较

Clinical effect comparison of hand type and traditional vacuum sealing drainage technology in treatment of hand soft-tissue defects

目的比较传统负压封闭引流技术(VSD)与手型VSD治疗手部软组织缺损伤的疗效,试图探索一个疗效性相对较好的方案。方法收集2014年3月至2015年6月期间在我院骨科住院治疗的手部软组织缺损伤患者共43例,分别采用传统VSD(A组)和手型VSD(B组)予以治疗,术后的患者均采取植皮手术。收集封闭负压引流液,之后进行细菌培养计数,统计两组患者的辅料使用天数、培养后的细菌数量以及植皮手术后的皮片存活面积比等指标。结果 A组患者辅料的平均使用时间为(2.3±1.6)d,明显短于B组的(5.2±1.2)d,差异有统计学意义(P<0.05);A组患者的细菌量为(5 320±1 030)CFU,明显多于B组的(455±121)CFU,差异有统计学意义(P<0.05);A组患者的皮片存活率为(90.3±2.6)%,明显低于B组的(97.5±1.7)%,差异有统计学意义(P<0.05)。结论手型封闭负压引流技术疗效性相对较好,有利于在手部创面中推广应用。

Objective Through comparing the efficacy of traditional VSD and hand VSD in treatment of hand soft-tissue defects, to explore a relatively good therapeutic solution. Methods A total of 43 patients with hand soft-tissue defects, who enrolled into our hospital from March 2014 to June 2015, underwent traditional vacuum closed drainage technique(group A, n=21) or hand type vacuum closed drainage treatment(group B, n=22). All postoperative patients underwent skin graft surgery. In progression of treatment, the drainage fluid was collected, then counted, and cell count was performed. The adjuvant material life, amount of bacteria and postoperative skin graft survival area were compared. Results Average adjuvant material life in group A [(2.3±1.6) days] was significantly shorter than group B [(5.2±1.2) days](P<0.05). The bacteria count of group A [(5 320 ± 1030) CFU] was significantly larger than group B [(455 ± 121) CFU](P<0.05). The postoperative skin graft survival area of group B [(97.5±1.7)%] was significantly higher than group A [(90.3±2.6)%](P<0.05). Conclusion Compared with traditional vacuum sealing drainage technology, the hand type vacuum sealing drainage effect is a relatively good therapeutic solution, which should be widely applied in the hand soft-tissue defects.