上肢骨折术后伤口负压引流管与普通引流管的比较

目的探讨上肢骨折术后伤口负压引流管与普通引流管对伤口引流量的影响。方法选取2018年8月至2019年8月的上肢闭合性骨折经过手术治疗患者44例,以电脑随机程序分为负压组(伤口负压引流)24例和普通组(普通伤口引流)20例。观察术后1 d、2 d及拔出引流管时伤口引流量及引流管放置时间;比较术前、术后血红蛋白含量及红细胞计数的改变情况;至少随访术后3个月观察其伤口愈合情况。结果术后1 d伤口引流量,普通组(30.65±10.10) m L显著少于负压组(63.78±30.37) m L(<0.05)。术后2 d普通组伤口引流量(13.32±7.68) mL与负压组(26.53±10.52) mL比较,差异无统计学意义(>0.05)。普通组所有患者均在术后2 d拔除伤口引流管,负压组中有7例患者术后3 d拔除引流管。引流管拔除时普通组总引流量为(46.96±23.76) mL,小于负压组(97.69±35.86) mL。术后3 d红细胞计数,负压组(3.06±0.69)×1012/L显著少于普通组(3.96±0.37)×1012/L(<0.05);术后3 d血红蛋白含量,负压组(97.56±14.68) g/L显著低于普通组(110.82±10.79) g/L(<0.01)。两组患者均未出现伤口并发症,术后伤口外渗量及换药次数无异常。结论上肢骨折术后普通引流管可减少伤口引流量并减轻血红蛋白的丢失且不增加伤口并发症。

Comparison of efficacy between negative pressure wound drainage and natural wound drainage of upper limb fracture after surgery

Objective To investigate the effect of negative pressure and natural on wound drainage of upper limb fracture after surgery. Methods This randomized controlled study included 44 patients (24 patients in negative pressure group and 20 in the natural group) with tourniquet in closed upper limb fracture surgery from August 2018 to August 2019. The total wound drainage and drainage tube placement time were observed at 1 d and 2 d after operation. The changes of hemoglobin content were compared before operation and after operation. The wound healing was observed for at least 3 months after operation. Results On the frist day postoperation, the natural of wound drainage was significantly less in negative pressure group as (30.65±10.10) mL than (63.78±30.37) mL in natural group (P<0.05). On the second day postoperation, the wound drainage in natural group of (13.32±7.68) mL, which was not significantly more than (26.53±10.52) mL in negative pressure group (P>0.05). All patients in the observation group had their wounds drained for 2 days after surgery. Ten patients in the negative pressure group had been removed drainage for 3 days after surgery. The drainage volume of natural group was (46.96±23.76) mL, which was less than (97.69±35.86) mL of the negative pressure group. The number of erythrocytes at the third day after operation in the negative pressure group was significantly less than the the control group(3.06±0.69)×1012/L vs. (3.96±0.37)×1012/L, P<0.05)]. The hemoglobin content at the third day after operation was significantly lower in negative pressure group (97.56±14.68) g/L)] than in the natural group (110.82±10.79) g/L], (P<0.01). There was no wound complications in both groups. No difference in wound extravasation and wound dressing change after surgery was noted. Conclusion The natural wound drainage can reduce the wound drainage and also reduce the hemoglobin loss without increasing the wound complications.