Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures

BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects.They were divided into a study group(n=40,healed with negative pressure closed drainage)and a control group(n=40,healed with conventional dressing changes)according to the variation in the healing they received.The efficacy of the clinical interventions,the variations in the regression indicators(time to wound healing,time to fracture healing,time to hospitalization),and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.RESULTS The total effective rate of patients among the study group was 95.00%(38/40),which was notably higher than 75.00%(30/40)among the control group(P<0.05).The wound healing time,fracture healing time,and hospital stay of the patients in the study group was shorter than the control group(P<0.05).After the intervention,the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group(P<0.05).CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury.It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.

置双腔管封闭负压持续引流联合中药加压灌洗治疗高位肛周脓肿的临床研究

目的观察置双腔管封闭负压持续引流联合中药加压灌洗治疗高位肛周脓肿的临床疗效及安全性。方法将76例患者按随机数字表法分为观察组与对照组各38例。观察组行切开引流后置双腔管封闭负压持续引流联合中药加压灌洗治疗,对照组行切开引流后凡士林纱条填塞结合0.9%氯化钠注射液冲洗治疗,观察两组患者近期及远期临床疗效、术后并发症、愈合进程及肛门功能等情况。结果观察组近期总显效率为92.11%,明显高于对照组的65.79%(P <0.05);观察组术后疼痛、发热评分改善优于对照组(P <0.01),脓腔容积缩小程度、创面愈合时间均明显优于对照组(P <0.01),远期形成脓肿、肛瘘等复发率低于对照组(P <0.01)。结论置双腔管封闭负压持续引流联合中药加压灌洗治疗高位肛周脓肿近、远期临床疗效满意,可减轻术后并发症,缩短愈合时间,保护肛门功能。

闭式滴注灌洗联合负压引流技术治疗感染性压疮或皮肤溃疡的临床效果

目的探讨闭式滴注灌洗联合负压引流技术(VSD)治疗感染性压疮或皮肤溃疡的临床效果。方法选择2016年7月～2018年6月由本院(包括总院)收入院的96例压疮或外伤后皮肤溃疡(未纳入糖尿病)患者作为研究对象,按照是否愿意参与本次课题研究分为对照组(34例)与治疗组(62例)。对照组仅采用传统换药与清除创伤面的手段,而治疗组则除此之外结合闭式滴注灌洗与VSD治疗,对比分析两组患者的各临床指标。结果治疗组的感染控制时间为(13.1±4.5)d,显著短于对照组的(21.4±5.2)d,差异有统计学意义(P<0.05)。治疗组患者中,新鲜溃疡创面吸引(10.0±0.8)d伤口植皮,其余创面时间为(14.5±2.5)d,个别病例换药至创面愈合,平均创面符合植皮手术时间为(14±2.6)d。治疗组的住院天数为(20.5±4.2)d,明显短于对照组的(27.4±3.6)d,但治疗组的住院费用明显多于对照组,差异有统计学意义(P<0.05)。治疗组经治疗后的总有效率(95.16%)明显高于对照组(58.82%),差异有统计学意义(P<0.05)。结论感染性压疮或皮肤溃疡患者应用闭式滴注灌洗结合VSD可以有效清除创伤面上的分泌物、坏死组织结构以及腔隙,治疗效果显著,建议广泛应用。

封闭式负压引流灌洗结合中医辨证治疗创伤性骨髓炎临床研究

目的探讨封闭式负压引流灌洗结合中医辨证治疗创伤性骨髓炎的临床效果。方法将80例创伤性骨髓炎患者随机分为两组,各40例。两组均给予病灶清创、敏感抗生素抗感染,术后行封闭式负压引流灌洗,观察组在上述治疗基础上给予中医辨证口服中药治疗,比较两组治疗效果。结果观察组创面愈合时间、抗生素使用时间及负压引流时间均短于对照组(P<0.01);术后3个月时,观察组总有效率高于对照组(P<0.05);术后随访1年,观察组复发率低于对照组(P<0.05)。结论封闭式负压引流灌洗结合中医辨证治疗创伤性骨髓炎,可有效缩短创面愈合时间、抗生素使用时间及负压引流时间,降低术后复发率,提高治疗效果。

庆大霉素持续用药灌洗与负压封闭引流术联用对胫腓骨骨折患者内固定术后抗感染的临床疗效评价

目的:评价庆大霉素持续用药灌洗与负压封闭引流术联用治疗对胫腓骨骨折患者内固定术后抗感染的临床疗效。方法:选取2017年1—8月间收治的行内固定术治疗的胫腓骨骨折术后感染患者120例资料,采用随机分组法将其分成A组和B组,每组60例;A组患者给予庆大霉素持续灌洗换药治疗,B组患者在以上治疗基础上加用负压封闭引流术治疗,比较两组患者治疗后的总有效率和骨折愈合时间的差异。结果:A组患者用药治疗后抗感染治疗的总有效率明显高于B组(P<0.05),骨折愈合时间明显早于B组(P<0.05)。结论:采用庆大霉素持续用药灌洗与负压封闭引流术联用治疗胫腓骨骨折内固定术后感染患者的临床治疗效果优于单用庆大霉素持续用药灌洗,其疗效较为确切,有效加快了骨折愈合。

人工真皮支架联合灌洗式负压封闭引流在肌腱或骨外露创面修复中的应用

目的分析使用人工真皮支架联合灌洗式负压封闭引流在肌腱或骨外露创面修复中带来的影响。方法选取2018年2月~2020年1月本院接受治疗的肌腱或骨外露创面修复患者60例,按照不同诊治的方式分为对照组和观察组各30例,给予对照组使用人工真皮支架,观察组采用人工真皮支架联合灌洗式负压封闭引流。观察两组的有效率和治疗前后生活能力评分。结果观察组有效率高于对照组,观察组的生活能力评分优于对照组。观察组的有效率高于90%,差异有统计学意义(P<0.05)。结论在人工真皮支架联合灌洗式负压封闭引流肌腱或骨外露创面修复可提高治疗的有效率,提高生活能力,值得在临床在推广。