间歇封闭负压创面治疗技术在急慢性创面修复中的应用

目的探讨间歇封闭负压创面治疗（suction wound closure therapy，SWCT）技术在创面修复中的应用，比较其与传统换药治疗的优缺点。方法将不同深度及大小的急、慢性创面220例随机分为两组，对比采用间歇封闭负压创面治疗（治疗组）和传统换药治疗（对照组）两种方法的应用。其中治疗组彻底清创后使用无菌生物半透膜覆盖创面，使用间歇负压泵调节负压（80～100mmHg），治疗时间（治疗5min，间歇2～3min）、持续时间依创面情况而定，3～7d换药一次。对照组使用无菌敷料覆盖创面，根据渗出量每天换药1～2次。比较两种治疗方法的效果、操作难易程度、患者耐受性、住院时间、住院费用等。结果急性创面愈合时间：治疗组1～2周（平均1．5周），对照组2～12周；慢性创面愈合时间：治疗组2～4周（平均3周），对照组2～32周。平均换药治疗费用：治疗组约1200元左右，对照组约2000元左右。治疗组创面愈合快、操作简单、患者易耐受、住院时间短、住院费用低。也有极少数患者出现贴膜过敏现象。结论间歇封闭负压创面治疗技术具有操作简单、无需特殊用药、创面愈合速度加快、减少医务人员工作量、减少交叉感染、降低医疗费、减少患者痛苦、患者易耐受等优点。

Intermittent suction wound closure therapy for the restoration of acute and chronic wounded areas

Objective To investigate the application of intermittent suction wound closure therapy for the restoration of wound, and to compare the advantage and the disadvantage between the intermittent suction wound closure therapy and the traditional dressing. Methods After the prospective task design, 220 patients were randomized into two groups according to the depth, size of the acute or chronic wounds. The treatment group were treated with the suction wound closure therapy, whereas the control group treated with traditional dressing. In the treatment group, we covered the wound with the sterile biologic semipermeable membrane after the thorough epluchage, then we regulated the negative pressure （ 80-100 mm Hg）, the treatment time （ working 5 minutes, rest 2 to 3 minutes）, the continuous time according to the condition of the wound, changed dressing every 3-7 days. In the control group, we coverd the wound with sterile gauze, changed dressing 1-2 times per day according to the amount of the seepage of the wound. The effectiveness, the way of operating, the tolerance of patients, the duration and the fee of hospitalization were compared between the two groups. Results The time of acute wound healing in the experimental group and the control group was 1 -2 weeks （averaging 1.5 weeks） and 2 - 12 weeks respectively, while the time of chronic wound healing in the experimental group and the control group was 2 - 4 weeks （averaging 3 weeks） and 2- 32 weeks respectively. The mean cost for treatment of changing dressing in the experimental group and the control group was about 1200 Yuan and about 2000 Yuan respectively. Compared with the control group, the patients in the treatment group were quickly recovered, the way of operating was easy and tolerable, the duration and the fee of the hospitalization were much lower, fewer cases were allergic to the transparent Adhesive membrane. Conclusion This technique has a lot of advantages, such as： the way of operating is easy, no special medication, is needed the hea