聚维酮碘外敷治疗感染性伤口的疗效观察

我院2000年6月至2001年12月应用聚维酮碘(碘伏)治疗感染性伤口47例,除2例因原发病恶化转外院治疗无法判断疗效外,其余45例均获良好效果,现总结如下。     

维生素C局部氧疗用于难治性感染性伤口换药

目的探讨维生素C局部氧喷在难治性感染性伤口中的应用效果。方法将60例难治性感染性伤口患者随机分为观察组（27例）和对照组（33例）。对照组用传统换药方式;观察组在常规清创后局部加用维生素C氧喷．外敷3M透明敷贴保持密闭湿润的环境。结果观察组治疗时间显著短于对照组,治疗费用显著低于对照组（均P〈0．01）,疗效显著优于对照组,但差异无统计学意义（P〉0．05）。结论维生素C局部氧喷有助于伤口愈合,缩短治愈时间,降低治疗费用。     

维生素C局部氧疗用于难治性感染性伤口换药

目的 探讨维生素C局部氧喷在难治性感染性伤口中的应用效果.方法 将60例难治性感染性伤口患者随机分为观察组(27例)和对照组(33例).对照组用传统换药方式;观察组在常规清创后局部加用维生素C氧喷,外敷3M透明敷贴保持密闭湿润的环境.结果 观察组治疗时间显著短于对照组,治疗费用显著低于对照组(均P＜0.01),疗效显著优于对照组,但差异无统计学意义(P＞0.05).结论 维生素C局部氧喷有助于伤口愈合,缩短治愈时间,降低治疗费用.     

内给氧治疗烧伤后低氧血症的疗效观察

严重烧伤后的组织缺氧,可引起毛细血管持久收缩,使细胞代谢发生改变。为探索新的给氧途径,笔者观察了注射用内给氧［碳酸酚胺过氧化氢ＣＯ（ＮＨ２）２·Ｈ２Ｏ２］对严重烧伤后低氧血症的治疗作用,报告如下。 资 料 与 方 法 １．病例选择：３０例住院患者,其中男性２６例,女性４例。年龄１８－４３岁,平均（２５．６ ±．６）岁。火焰烧伤２２例,火药（炸）烧伤８例,所有患者烧伤面积均＞５０％ＴＢＳＡ,Ⅲ度＞２５％ＴＢＳＡ。入院后按常规抗休克、抗感染和手术治疗的同时作血气分析,３０例患者的动脉血氧分压均低于８ ｋＰａ…     

给氧方式对全麻插管安全时限的影响

目的 研究给氧方式对全麻插管安全时限的影响.方法 妇科手术患者75例.按诱导给氧方式随机均分为三组:A组,潮气量呼吸3 min后行快速顺序诱导(RSI);B组,30 s内深呼吸4次后行RSI;C组,常规诱导正压通气.所有患者的吸人氧流量均为5 L/min.气管插管后待SpO2降至90%再迅速连接导管和麻醉机进行手控正压通气.记录各组无通气安全时间、气管插管时间、观察期内最低SpO2和最高PETCO2.每组随机选8例分别在诱导前、停通气即刻、spO2降至90%时采动脉血进行血气分析.插管安全时限在C组即为无通气安全时间,在A、B组则为无通气安全时间减60 s肌松起效时间.结果 A组无通气安全时间为(471.9±100.9)s,明显长于B组的(359.0±95.7)s和C组的(378.1±109.2)s(P＜0.05),插管安全时限A组为(411.9士134.8)s,C组为(378.1±109.2)s,均明显长于B组[(299.8±95.7)s](P＜0.05),三组实际插管时间超过50 s的共3例,均没有超过各组插管安全时限的最低值.结论 潮气量呼吸预给氧3 min后行RSI与常规诱导面罩正压通气所获得的插管安全时限是相同的,情况紧急时30 s内深呼吸4次行RSI尽管插管安全时限比常规诱导短,但也能满足绝大多数患者的插管要求.     

高压氧治疗中直流给氧人数对舱内氧浓度的影响

为探讨高压氧治疗时 ,直流给氧对氧浓度升高的影响 ,将 18例神经外科术后进行高压氧治疗的病人分为A、B、C三组 ,每组 6例。直流给氧A组 3例 ,B组 2例 ,C组 1例 ;其他为面罩给氧。每组分别监测氧舱内氧浓度变化(均监测 5次 )。结果A组与B、C组比较 ,差异有显著性意义 (均P <0 .0 5 )。提示直流给氧的人数越多氧舱内氧浓度越高     

经皮给药治疗轮状病毒感染性腹泻的疗效观察

轮状病毒感染是感染性腹泻最常见的病因 ,其治疗方法常采用口服或静脉给药。 1999年 10月至2 0 0 1年 10月 ,我院儿科在口服及静脉给药的同时辅以经皮给药治疗轮状病毒感染性腹泻患儿 2 0 3例 ,收到了满意的效果 ,报道如下。1　资料与方法1 1一般资料本组 2 0 3例 ,男 113例、女 90例 ,月龄 0～ 6个月 5 2例 ,～ 12个月 84例、～ 2 4个月 5 3例、～ 36个月 14例。大便每天 5～ 12 (9 5± 2 6 )次 ,均经大便轮状病毒抗原检测确诊。随机分为观察组和对照组 ,观察组 10 5例 ,对照组 98例。两组年龄、性别、病情、病程比较 ,异差无显著性意义 (…     

正压接头在静脉留置输液中的留置时间研究

目的:分析正压接头在静脉留置输液中的留置时间.方法:将80例需要静脉输液的病人随机分为现察组与对照组各40例,对照组采用外接肝素帽,观察组采用外接正压接头.结果:观察组取得置管时间延长的满意效果.结论:正压接头留置时间长于肝素帽留置时间.     

芒硝溶液持续滴注结合负压封闭引流技术（VSD）治疗腹部感染性伤口的应用研究

目的为促进腹部感染性伤口的恢复,降低伤口耐药的发生率,在负压封闭引流技术(VSD)的基础上持续滴注芒硝溶液,与传统生理盐水滴注对比并评估其疗效,为治疗腹部手术部位感染提供更加有效经济的新方法。方法收集2018年1月至2018年12月南昌大学第二附属医院胃肠外科和中山大学附属第六医院胃肠、疝和腹壁外科收治的腹会阴部手术后出现伤口感染且较难愈合,伤口清创后予以负压封闭引流术的80例患者。随机将其分为两组,试验组40例,持续滴注芒硝溶液结合负压封闭引流技术,对照组40例,持续滴注生理盐水结合负压封闭引流技术,观察比较两组患者清创后创面新鲜肉芽覆盖情况、术后疼痛缓解情况、伤口达二期缝合时间、伤口缝合后愈合时间、换药总费用等。结果在相同时间内试验组患者的创面肉芽组织生长情况评分为(3.97±0.42),明显好于对照组(2.25±0.44),伤口达二期愈合时间为(11.75±1.69 d),明显短于对照组(16.4±2.74 d);试验组患者手术后疼痛评分为(2.87±0.36),明显低于对照组(4.05±0.85);试验组患者伤口缝合后愈合时间为(7.15±1.63)天较对照组(10.27±2.89)天明显缩短;试验组患者换药次数及费用明显低于对照组,以上差异均有统计学意义(P0.05)。结论持续滴注芒硝溶液结合负压封闭引流技术可以显著促进腹部感染性伤口的快速恢复,减轻患者负担,节约医疗资源,为临床治疗腹部感染性伤口提供更加经济有效的方案。     

Hyperbaric oxygen therapy with topical negative pressure: an alternative treatment for the refractory sternal wound infection

Sternal osteomyelitis is a potentially lethal complication after cardiac surgery. It may be the cause of postoperative morbidity and mortality. We present a case of deep sternal wound infection after sternotomy. The patient received three treatments of surgical debridement, irrigation, topical negative pressure (TNP) dressing, and hyperbaric oxygen (HBO) therapy. Forty-five HBO therapy sessions were administered. After nine weeks, the sternal wound was healed and completely epithelialized. This conservative therapy can be an alternative and inexpensive method for the difficult sternal wound infection patient.     

纳米银结合局部氧疗用于痔术后创面换药

目的探讨纳米银结合局部氧疗促进痔术后创面愈合的效果。方法将197例痔术后患者随机分为观察组(99例)和对照组(98例)。观察组于术后外敷纳米银外用抗菌凝胶结合局部氧疗;对照组行常规换药。结果观察组创面愈合时间显著短于对照组,术后3d、7d水肿及出血评分显著低于对照组(P0.05,P0.01)。结论纳米银外用抗菌凝胶结合局部氧疗能改善痔术后出血及水肿等症状,缩短创面愈合时间。     

Clinical research on the bio‐debridement effect of maggot therapy for treatment of chronically infected lesions

Objective: To evaluate the bio‐debridement effect of maggot therapy for treating chronically infected lesions. Methods: A retrospective study was conducted of 25 patients with diabetic foot ulcers and 18 patients with pressure ulcers after spinal cord injury treated by maggot therapy or traditional dressing. Changes in the lesions were observed and bacterial cultures tested. Results: All ulcers healed completely. The times taken to achieve bacterial negativity, granulation and healing of lesions were all significantly shorter in the maggot therapy group than in the control group, both for diabetic foot ulcers (P < 0.05) and pressure ulcers (P < 0.05). Conclusion: Maggot therapy is a safe and effective method for treating chronically infected lesions.     

负压创面治疗联合高压氧治疗糖尿病足的临床疗效

目的 探讨负压创面治疗联合高压氧治疗糖尿病足的临床疗效.方法 采用回顾性病例对照研究分析江苏大学附属人民医院整形烧伤科自2013年2月至2017年12月收治的46例糖尿病足患者的临床资料,根据治疗方法分为对照组(24例)和联合治疗组(22例).糖尿病足创面按Wagner分级为3～5级;共46足.对照组采用控制血糖、抗感...     

The use of vacuum-assisted closure therapy for the treatment of a large infected facial wound

Chronic wounds in difficult locations pose constant challenges to health care providers. Negative-pressure wound therapy is a relatively new treatment to promote wound healing. Laboratory and clinical studies have shown that the vacuum-assisted closure (VAC) therapy increases wound blood flow, granulation tissue formation, and decreases accumulation of fluid and bacteria. VAC therapy has been shown to hasten wound closure and formation of granulation tissue in a variety of settings. Accepted indications for VAC therapy include the infected sternum, open abdomen, chronic, nonhealing extremity wounds and decubitus ulcers. We report the first case of VAC therapy successfully used on a large infected wound to the face to promote healing.     

Managing the open wound: indications for topical negative pressure therapy

Surgeons frequently encounter open wounds. These include wounds which have failed to close by primary means, wounds which are left open at the outset and wounds which fail to heal by secondary intention in a timely manner. Wound healing is a complex process involving tissue repair and remodelling at the same time as removal of necrotic tissue and foreign material. Topical negative pressure (TNP) is a wound management technique which applies subatmospheric pressure to a healing wound in an attempt to facilitate healing. The potential mechanisms of action of TNP are poorly understood and may involve mechanical and biochemical effects. TNP has been suggested to be of value in a variety of settings, ranging from management of acute wounds to ischaemic and diabetic ulcers. There has been inadequate scientific evaluation of TNP, which has rarely been subjected to rigorous clinical trials or adequate effective economic evaluation. Although in general TNP does appear to be largely safe and acceptable to patients, the risk of fistulation associated with its use in the open abdomen remains to be determined and is currently being evaluated by a national audit.     

Systematic review of the efficacy of topical haemoglobin therapy for wound healing

Hypoxia is a common cause of poor wound healing, for which a variety of oxygen therapies have been developed. In order to overcome the limitations of traditional methods of treatment, namely the type of equipment, its setting, safety and cost, local haemoglobin therapy has been developed, although no reviews have so far been published. Here, we systematically review the current evidence to establish the efficacy, scope, adverse reactions, and required precautions of this new form of therapy. A search of the literature was conducted in the PubMed, Embase, Scopus, CENTRAL, CINAHL, and Web of science databases, with 17 studies meeting the eligibility criteria, comprising one animal model study and 16 clinical studies. Local haemoglobin therapy is able to safely and effectively promote the healing of a variety of wounds, especially those that are chronic and non‐healing. However, premature discontinuation of this treatment can result in impediment to wound healing and even deterioration of the wound. The distinct benefit of the elimination of slough and relief of pain suggests that this technique may represent a new generation of debridement technology. Furthermore, its ease of use and convenience enables patient self‐management, thereby greatly reducing health care costs.     

局部真空疗法治疗感染伤口效果的观察及护理

目的观察真空疗法(VAC)治疗深部感染的效果,探讨感染伤口患者护理方法的改进。方法36例深部感染患者随机分为VAC治疗组(24例)和传统方法组(12例),观察两种方法治疗5天后切口引流量的变化、切口引流物细菌含量变化及切口愈合时间的差别。结果VAC治疗5天,切口引流量减少量显著高于传统方法组,切口渗液细菌浓度较传统方法组下降(P<0.05),切口愈合时间较传统方法组显著缩短。结论VAC能抑制深部感染,促进深部感染愈合,可广泛用于治疗深部感染。     

Effect of oxygen treatment and dressing oxygen permeability on wound healing

Although it has been shown that both the level of tissue oxygen and its gradient are critical factors in the healing process, optimal conditions for oxygen therapy have not been determined. In this study, both the oxygen level and oxygen gradient for a full-thickness defect were modified on the basis of preceding in vitro studies to determine the effect on the healing process. The goal of this study was to help determine the optimal clinical oxygen treatment protocol. Specifically, the healing of full-thickness defects in a rabbit model as determined by histomorphometric analyses (cell and tissue volume fraction, epithelialization, and contraction) under two types of dressings with or without oxygen treatment (70% O(2)) was investigated. One of the dressings was more oxygen permeable than the other. No significant differences were found in the histomorphometric response between the wounds covered with the oxygen-permeable and oxygen-impermeable dressings in the group without supplemental oxygen. Oxygen treatment, however, seemed to enhance the healing response significantly. According to the histomorphometric response, the wounds covered with the oxygen-impermeable dressings were significantly better than those with the oxygen-permeable dressing in the oxygen-treated group after 1 week, but the wounds covered by the oxygen-permeable dressings were better healed at 3 weeks. Therefore, oxygen-impermeable dressings may be useful only in the early stages of healing, before granulation tissue formation.