闭式灌洗法在组织瓣修复皮肤软组织缺损伴伤口感染中的应用  

Application of closed type douche in repairing of skin and soft tissue defect with wound infection by tissue flap

作　　者：赵兵清[1] 刘昕[1] 周利江[1] 孙海文[1] 

机构地区：[1]中国人民解放军第421医院 骨科,广东 广州510318

出　　处：《实用手外科杂志》2014年第1期53-54,60,共3页Journal of Practical Hand Surgery

摘　　要：目的：探讨降低组织瓣修复软组织缺损并感染创面后感染复发率的方法。方法 A组38例经组织瓣修复的皮肤软组织缺损伴创面感染者，伤口采用温盐水闭式灌洗法；B组29例为组织瓣修复的皮肤软组织缺损伴创面感染者，伤口采用半胶管或胶管负压引流，比较两组术后创面感染复发及皮瓣坏死率。结果术后随访9～12个月，A组出现创面感染复发率为5.26%，皮瓣部分坏死率为18.42%；B组出现创面感染复发率为20.69%，皮瓣部分坏死率为27.59%。两组创面感染复发率差异有统计学意义（P＜0.05），但两组的皮瓣坏死率差异无统计学意义（P＞0.05）。结论闭式灌洗法能有效降低伤口感染复发率，但对组织瓣的成活无明显影响。Objective To approach a way to lower the recurrence rate of wound infection in infective raw surface and soft tissue defect restored by tissue flap. Methods The wounds of 38 patients in group A, whose defects of skin and soft tissue with wound infection were restored by tissue flap were treated by closed type douche with warm saline water. The wounds of 29 patients in group B, whose defects of skin and soft tissue with wound infection were restored by tissue flap were drained by half sebific duct or sebific duct with negative pressure. To compare the recurrence rate of wound infection and necrosis rate of tissue flap of two group. Results After 9 to 12 months follow up, the recurrence rate of wound infection of group A was 5.26%, the necrosis rate of tissue flap of group A was 18.42%. The recurrence rate of wound infection of group B was 20.69%, the necrosis rate of tissue flap of group B was 27.59%. There was statistical significance in the recurrence rate of wound infection between the two groups, but there wasn＆#39;t statistical significance in the necrosis rate of tissue flap between the two groups. Conclusion Closed type douche is effective to lower the recurrence rate of wound infection, and there is no bad to tissue flap.

关 键 词：闭式灌洗法 组织瓣 伤口感染 

分 类 号：R622.1[医药卫生—整形外科]