骨科创伤中持续负压密封引流与普通换药治疗切口感染的效果分析

目的观察持续封闭负压引流术(vacuum-sealing drainage,VSD)与普通换药法在骨科创伤中临床疗效。方法骨科手术切口感染患者44例,采用随机数字表法,将患者随机分为VSD实验组24例和普通换药组20例,比较两组患者感染切口的清洁时间、愈合时间、感染的并发症、患者满意度评价,比较VSD与普通换药的疗效差别。结果 VSD实验组的清洁时间为(4.50±1.25)d、伤口愈合时间为(8.45±1.90)d,均明显少于普通换药组[(9.60±1.50)d,(13.40±2.45)d],差异有统计学意义(P0.05);VSD组创面并发症发生率为16.6%(4/24)明显低于普通换药组(55.0%,11/20),差异有统计学意义(P0.05);VSD实验组患者满意度为(9.10±0.95)分,明显高于普通换药组[(5.35±1.58)]分,差异有统计学意义(P0.05)。结论负压封闭引流术技术能彻底去除腔隙或创面分泌物和坏死组织,促进创面愈合,疗效显著、使用安全、操作简便,是治疗骨科手术切口感染的简单有效方法。

Clinical comparison between continuous vacuum sealing drainage and ordinary dressing in treatment of orthopedic surgical incision infection

Objective To compare the clinical efficacy of continuous vacuum sealing drainage and ordinary dressing in treatment of orthopedic surgical incision infection. Methods 44 cases with orthopedic surgical incision infection admitted by our hospital during March 2012 to March 2013 were enrolled and randomly divided into the VSD group of 24 cases and the ordinary dressing group of 20 cases. The debridement time of incision infection,healing time,infective complications incidence and patient satisfaction were analyzed. Results The debridement time of incision infection and healing time of VSD group were4. 50 ± 1. 25 d,8. 45 ± 1. 90 respectively,significantly shorter than those of the ordinary dressing group（ 9. 60 ± 1. 50 d and 13. 40 ± 2. 45 d）（ P 〈 0. 05）. The infective complications incidence of the VSD group was 16. 6%,lower than that of the Ordinary dressing group with 55. 0%（ P 〈 0. 05）. The patients satisfaction score of the VSD group was 9. 10 ± 0. 95,higher than that of the Ordinary dressing group（ 5. 35 ± 1. 58）（ P 〈 0. 05）. Conclusion As an innovative surgical drainage technique,VSD can completely remove the lacuna,wound secretions and necrotic tissues,and promote wound healing compared with ordinary dressing.VSD is a simple and effective method in treatment of orthopedic surgical incision infection,worthy of clinical promotion and application.