简易负压封闭引流在开放性下肢骨折一期术后皮肤缺损感染控制中的应用研究  

Effect of simplified vacuum sealing drainage on control of skin defect infections after first stage surgery for open fracture of lower extremities

作　　者：高远[1] 屈波[1] 张浩[1] 孔丹[1] 陈雪梅[1] 皮红英[1] 

机构地区：[1]解放军总医院骨科一病区,北京100853

出　　处：《中华医院感染学杂志》2014年第18期4582-4584,共3页Chinese Journal of Nosocomiology

基　　金：解放军总医院临床科研基金资助项目(2013FC-GLCX-1001)

摘　　要：目的探讨简易负压封闭引流装置对开放性下肢骨折一期术后皮肤缺损感染控制中的治疗作用与护理要点,以降低感染率。方法选取2011年12月-2013年4月收治的26例开放性下肢骨折一期术后皮肤缺损患者作为研究组,采取自制简易负压封闭引流装置对创面进行处置,并进行严密观察和护理;选取2011年12月以前常规敷料包扎治疗开放性下肢骨折一期术后皮肤缺损患者32例为对照组,采取常规换药处理及常规护理,比较两组二期手术的达标率,并比较一期手术后至二期手术期间住院天数、换药次数。结果研究组创面达标率为100.0%,平均住院时间为(9.2±3.4)d,平均换药次数为(3.8±1.2)次;对照组达标率为84.4%,平均住院时间为(14.7±4.5)d,平均换药次数为(6.3±3.6)次,两组比较差异有统计学意义(P<0.05)。结论简易负压引流法可促进下肢开放性骨折一期术后皮肤条件改善,显著减少住院时间和换药次数,减轻护理工作量,减轻患者费用负担,提高患者满意度,具有较高的临床应用价值。OBJECTIVE To explore the effect of simplified vacuum sealing drainage on control of skin defect infec-tions after first stage surgery for open fracture of lower extremities and analyze the key points of nursing so as to reduce the infection rate .METHODS From Dec 2011 to Apr 2013 ,totally 26 patients who underwent the first stage surgery for open fracture of lower extremities and were complicated with postoperative skin defect were assigned as the study group ,the wounds were treated by using self-designed simplified vacuum sealing drainage device ,and close observation and nursing were conducted ;before Dec ,2011 ,32 patients who underwent the first stage sur-gery for open fracture of lower extremities and were complicated with postoperative skin defect were set as the con-trol group and treated with conventional drug dressing and conventional nursing ;the compliance rate of second phase operation conditions （CR） ,hospitalization duration between the end of first phase surgery and the second phase surgery ,and frequency of dressing were observed and compared between the two groups .RESULTS The compliance rate of wound treatment was 100 .0% in the study group ,84 .4% in the control group ;the mean hos-pitalization duration was （9 .2 ± 3 .4） days in the observation group ,（14 .7 ± 4 .5）days in the control group ,the average frequency of drug dressing was （3 .8 ± 1 .2） times in the observation group ,（6 .3 ± 3 .6） times in the con-trol group ,and there was significant differences between the two groups （P＆lt;0 .05） .CONCLUSION The simplified vacuum sealing drainage can contribute to the improvement of skin condition after the first phase surgery for open fracture of lower extremities ,remarkably reduce the hospitalization duration and frequency of drug dressing as well as the nursing workload ,lighten the financial burden ,and improve the patients′satisfaction ,it has great clinical value .

关 键 词：简易负压封闭引流 开放性下肢骨折 皮肤缺损 

分 类 号：R619.3[医药卫生—外科学]