持续负压封闭引流在预防急性软组织创伤创面感染中的应用

目的探讨持续负压封闭引流技术对预防急性软组织创伤创面感染的作用。方法将80例由各种原因所致的急性创伤（创面）分为A组40例（治疗组），B组40例（对照组）。A组常规创面清创后利用持续封闭式负压引流覆盖创面；B组常规对创面进行清创然后用生物敷料A覆盖后包扎换药。伤后、术前及术后第7天取创面标本做细菌培养；观察伤后7d内创面的红肿程度，7d后两组按照创面情况选用不同手术方式治疗修复创面，骨外露或肌腱等外露者采取皮瓣修复创面，其余采取游离皮移植修复。结果手术后7d，A组创面细菌培养阳性6例，细菌感染率为15．0％；B组创面细菌培养阳性22例，细菌感染率为55．0％。A组创面感染率明显低于B组，差异有统计学意义（x2=14．066，P=0．000）。术后A组创面肿胀较B组轻，差异有统计学意义（u=-2．035，P=0．042）。A组病人创面修复愈合平均时间明显短于B组，差异有统计学意义（t=-3．466，P=0．001）。结论急性软组织创伤（创面）使用持续负压封闭引流技术能较有效地降低创面感染率，利于创面愈合。

Application of continuous vacuum sealing drainage technique in the prevention of wound infection in acute soft tissue trauma

Objective To explore the effect of continuous vacuum sealing drainage （VSD） technique in the prevenction of wound infection in acute soft-tissue trauma. Methods Eighty cases of acute traumatic wounds caused by various reasons were divided into two groups at random. Of them 40 cases were treated by covering wonds with continuous VSD after general wound debridement （treatment group, groupA） and the other 40 cases were treated by regular debridement of the wound followed by covering biolagical dressing A （control group, group B）. The specimen was taken form injured area for bacterial culture on preoperative and 7th postoperative day ; the wound swelling degree were observed within 7 days of trauma. According to the condition of wounds patients in tow groups were choosed dif- ferent surgical methods for wound repair 7days later. Results In group A the positive bacterial cultures was found in 6 cases ,the wound infection rate was 15.0% ,which was significantly lower than the group B （22 cases,55% ）, （X2 = 14.066 ,P =0. 000）. Wound swelling degree of group A tend to be slighter than that of group B（ u = - 2. 035 ,P = 0. 042）. The average time of wound healing in group A was significantly shorter than that in group B （ t = - 3.466,P = 0. 001）. Conclusion Using continuous VSD technique in acute soft tissue trauma can reduce the wound infection rate, and facilitate wound healing.