液体敷料在包皮环切术后换药中的临床应用价值

目的:探讨并分析液体敷料在包皮环切术后缓解疼痛、预防切口粘连的效果及其临床应用价值。方法:收集2019年9~11月在杭州市第三人民医院泌尿外科行包皮环切术的患者90例,随机分为3组,每组30例,A组术后切口采用液体敷料+凡士林纱布覆盖;B组术后切口采用液体敷料覆盖;C组术后切口采用凡士林纱布覆盖。比较3组患者术后第2、4、6天换药时VAS疼痛评分、去除敷料后渗血及并发症发生情况。结果:术后第2、4、6天换药时,A、B两组患者VAS疼痛评分、切口渗血率明显低于C组(P<0.05);与B组相比,A组术后第2天,VAS疼痛评分、切口渗血率均显著下降(P<0.05);术后第4、6天,除疼痛评分仍有差异外(P<0.05),切口渗血率并无明显统计学差异(P>0.05);3组患者术后并发症发生率则无明显统计学差异(P>0.05)。结论:液体敷料能够减轻包皮环切术后换药疼痛,防止换药时因粘连而引起的切口撕裂渗血,进而加快切口愈合,联合凡士林纱布使用,效果更佳。

Clinical application value of liquid dressing after circumcision

Objective: To explore and analyze the effect of liquid dressing in relieving pain and preventing incision adhesion after circumcision and its clinical application value. Methods: Ninety male patients underwent circumcision in Hangzhou Third People’s Hospital from September to November 2019, with the incision covered with liquid dressing + vaseline gauze(group A, n = 30), liquid dressing alone(group B, n = 30) or vaseline gauze only(group C, n = 30). At 2, 4 and 6 days after surgery, we compared the Visual Analogue Scale(VAS) pain intensity at dressing change, incision bleeding after dressing removal and incidence of postoperative complications among the three groups of patients. Results: At 2, 4 and 6 days after surgery, the VAS pain score and incidence of incision bleeding were significantly lower in groups A and B than in C(P < 0.05). At 2 days, both the VAS pain score and incidence of incision bleeding were markedly decreased in group A as compared with those in group B(P < 0.05). At 4 and 6 days, the VAS pain score remained lower in group A than in B(P < 0.05), but the incidence rate of incision bleeding showed no significant difference between the two groups(P > 0.05). No statistically significant differences were observed in the incidence of postoperative complications among the three groups(P > 0.05). Conclusion: Liquid dressing can reduce pain intensity at dressing change, prevent incision adhesion and consequent dressing change-induced tearing and bleeding, and therefore promote incision healing after circumcision. Its combination with vaseline gauze can achieve an even better effect.