手部外伤清创缝合质量的有关因素分析(附100例分析)  

FACTORS INFLUENCING THE QUALITY OF DEBRIDEMONT AND SUTURE IN HAND TRAUMA: AN ANALYSIS OF 100 CASES

作　　者：严计赓 顾玉东[1] 潘桂珍[2] 

机构地区：[1]上海医科大学附属华山医院手外科 [2]上海医科大学附属华山医院细菌室

出　　处：《上海医学》1988年第12期697-700,共4页Shanghai Medical Journal

摘　　要：作者对近期100例急诊手外伤患者清创术前、术后的细菌学、抗菌药物的敏感性等方面进行了研究,结果表明:(1)术后致病菌的检出率明显低于术前,说明以两套消毒衣、器械的方法是预防感染的重要环节。(2)近期的主要致病菌是金葡菌、大肠杆菌、绿脓杆菌、奇变杆菌、产气杆菌。并提出致伤环境应分为两大类,以便于指导清创术。(3)药敏表明庆大霉素、复方新诺明可作为清创术时的常规用药。(4)两种不同方法处理创面的结果表明,当皮肤缺损不能以3-0丝线拉拢缝合时,应采用皮瓣转移、植皮覆盖创面。One hundred consecutive cases of hand trauma treated between Dec 1985 to April 1986 were studied prospectively for the factors influencing the outcome.In 35 finger injuries,the wound was sutured under tension in 15 and grafted with full thickness skin in 20.Ninety-nine cases healed by first intension and 1 case was infected.Twelve of the 15 fingers sutured under tension had protuberant scar and motion of the finger was affected in various degrees,while the 20 fingers with skin graft did not.It was found that change of new sterile instruments,drapes and surgical gown after thorough debridemont was an important procedure.Pyogenic bacteria were obtained in culture 14 times before debridemont and were reduced to 2 times after debridemont.Sensitivity tests revealed that gentami cin and compound SMZ should be used prophylactively.

关 键 词：致病菌 金葡菌 检出率 清创术 常规用药 伤口 病原微生物 杆菌 庆大霉素 艮他霉素 质量 

分 类 号：R47[医药卫生—护理学]