负压技术治疗复杂性和难愈性创面疗效观察

目的 了解负压创面治疗技术(NPWT)治疗复杂性和难愈性创面的效果.方法 选择2005年9月-2008年11月因复杂性和难愈性创面入住笔者单位治疗的67例患者,按随机化方法分为负压治疗组35例和常规治疗组32例.负压治疗组患者创面给予压力-16.63 kPa行24 h间断吸引,或以-10.64 kPa压力行24 h持续吸引.常规治疗组患者创面覆以凡士林纱布并加盖等渗盐水湿纱布及干纱布.比较2组患者治疗时间、手术次数、治疗费用及治愈方式. 结果负压治疗组患者在治疗时间、手术次数、治疗费用上均明显低于常规治疗组(P<0.05).负压治疗组治愈方式以自行愈合(40.0%)及游离皮片移植后愈合(40.0%)为主,常规治疗组则以带蒂组织瓣移植(66.7%)和游离皮片移植(23.3%)后愈合为主. 结论与常规治疗相比,NPWT治疗复杂性和难愈性创面后可缩短患者住院时间,降低手术难度,减少手术次数及治疗费用等,值得推广.

Observation on the therapeutic effects of negative-pressure wound therapy on the treatment of complicated and refractory wounds

Objective To study the effects of negative-pressure wound therapy (NPWT) on the treatment of complicated and refractory wounds. Methods Sixty-seven patients with complicated or refrac-tory wounds admitted to our hospital from September 2005 to November 2008 were randomly divided into NPWT group ( n = 35 ) and conventional treatment (CT) group ( n = 32). Wounds of patients in NPWT group were treated with interrupted suction under a pressure of - 16.63 kPa for 24 hs, or continuous suction under a pressure of - 10.64 kPa for 24 hs. Wounds of patients in CT group were covered with petrolatum gauze overlaid with isotonic saline gauze and dry gauze. Duration of treatment, times of operation, treatment cost, and the process of healing were compared between two groups. Results The duration of treatment, treatment cost and times of operation of patients in NPWT group were obviously less or fewer than those of CT group ( P < 0. 05). Wounds of patients in NPWT group were mainly healed by themselves (40.0%) or healed after free skin grafting (40. 0% ). While wounds in patients in CT group healed mainly after tissue flap transplantation (66.7%) or free skin grafting (23.3%). Conclusions Compared with CT, NPWT can shorten the length of hospital stay, reduce operation frequency and treatment cost, and it is easier to car-ry out in the surgery of treating complicated and refractory wounds, which is worth generalization.