应用研究

简易负压封闭引流技术在25例腹部创伤患者感染切口中的应用效果

李永刚 李 平 赵光锋 廖 文 谭 浪 吴 燕*

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【摘要】  目的 观察简易负压封闭引流技术在腹部创伤患者感染切口中的应用效果。方法 对照组(n=25)给予现有负压封闭引流VSD材料治疗感染切口,观察组(n=25)给予简易负压封闭引流技术治疗感染切口,对比两组的冲洗引流效果、肉芽组织生长影响、耗材费用及切口愈合时间。

【关键字】  腹部创伤,简易负压封闭引流技术,感染切口,愈合,耗材费用

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[Abstract] Objective This study aims to observe the application effect of simple negative pressure sealing drainage technique in the infected incision of patients with abdominal trauma. Methods The control group (n=25) was treated with the existing negative pressure sealing drainage VSD material to treat the infected incision, and the observation group (n=25) was treated with the simple negative pressure sealing drainage technology to treat the infected incision. It compared the effect of washing and drainage, the effect of granulation tissue growth, the cost of consumables and the time of wound healing. Results There were 24 patients (96.00%) with smooth irrigation and drainage in both groups, 1 case (4.00%) with pipeline blockage and poor drainage in VSD, and there was no significant difference in the effect of irrigation and drainage between the two groups (χ2=0.000, P=1.000). In the observation group, 22 cases (88.00%) had clean wounds, rosy granulations, and self-healing incisions after VSD, 3 cases (12.00%) needed to use VSD twice or more, and intermittent sutures after debridement. In the control group, 22 cases (88.00%) had clean wounds, rosy granulations, and self-healing incisions after VSD, 3 cases (12.00%) who needed VSD for 2 or more times, and intermittent sutures after debridement of incisions, and there was no significant difference in the growth effects of granulation tissue between the two groups (χ2=0.000, P=1.000). In the observation group, the consumables cost of 50 yuan for 14 cases (56.00%), 100 yuan for 5 cases (20.00%), 150 yuan for 3 cases (12.00%), and 3 cases (12.00%) for intermittent suture after local anesthesia debridement after incision, a total of 2 550 yuan was used. Each patient in the control group was free of charge with one existing disposable negative pressure drainage protection material (moisturizer), worth 3 280 yuan per piece, of which 19 patients used one post-granulation ruddy and incision healing without follow-up costs; 3 patients used one more, with a total cost of 9840 yuan; Two patients added intermittent sutures after local anesthesia debridement after using two VSD consumables, the cost was 13 120 yuan, and 1 patient added three VSD consumables after incision local anesthesia debridement intermittent suture with 9 840 yuan. The usage fee is 32 800 yuan. Compared with the use of consumables between the two groups, the cost of consumables in the control group was 12.86 times that of the observation group on the basis of removing free use, which was much higher than that of the observation group. The incision healing time of all patients was (11.96±3.61) d, and the incision healing time of the control group was (11.52±3.22) d, and there was no significant difference in the incision healing time between the two groups (t=0.455, P=0.651). Conclusion Simple VSD has the same irrigation and drainage effect as existing VSD in patients with abdominal trauma infection, and the granulation tissue of the two groups after VSD is grown red, the incision heals well, there is no significant difference in healing time, and the effect is comparable, which promotes the effective healing of infected wounds. However, the cost of using simple VSD consumables is significantly lower than the cost of existing VSD consumables, which reduces the economic burden of patients.

腹部创伤在临床外科中较为常见,不同程度损伤患者机体血管神经及肌肉等软组织。若切口发生感染,导致切口愈合延迟,增加腹腔感染风险,严重影响患者预后情况,降低医疗服务质量[1-2]。抗生素及常规换药治疗,是临床应对腹部创伤感染的主要方法,具有良好的临床效果,但存在切口暴露、耐药性等问题,在一定程度上影响临床效果[3-4]。近年来,随着医疗技术的不断发展进步,负压封闭引流技术(vacuum sealing drainage,VSD)在临床腹部创伤及感染等的治疗过程中具有积极的临床意义[5]。VSD是通过生物膜将空气隔离,制造局部密闭空间,控制维持负压以有效抑制感染,促进创面愈合[6]。VSD操作简单,可实时观察监测引流物的形状及流量等,降低交叉感染风险,缩短临床疗程[7]。本研究将简易VSD应用于腹部创伤患者感染切口中,旨在探讨简易VSD的临床应用价值,为临床干预指导提供科学理论依据。 1 资料与方法 1.1 一般资料 将我院2022年1月至2022年6月收治的50例腹部创伤切口感染患者,按照入院时间先后顺序将患者依次编号,按照单双数随机分为观察组25例,对照组25例。观察组男14例,女11例;年龄22~86岁,平均(48.48±16.75)岁。对照组男14例,女11例;年龄19~68岁,平均(44.28±12.19)岁。两组患者性别、年龄等一般资料均差异无统计学意义(P>0.05),具有可比性。患者的临床资料完整,在《知情同意书》上签字,所有调查对象的临床资料递交伦理委员会审核并获得批准。

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