冲洗液量对预防开放骨折创面感染的细菌学研究  

Bacteriological study of the relation between flushing volume and prevention for wound infection of open fracture

作　　者：王斌[1] 王桂华[2] 刘新晖[1] 杨业林[1] 朱超[1] 孙超[1] 

机构地区：[1]南京医科大学附属江宁医院骨二科,江苏南京211100 [2]南京医科大学附属江宁医院院内感染科,江苏南京211100

出　　处：《临床骨科杂志》2015年第1期90-92,共3页Journal of Clinical Orthopaedics

摘　　要：目的检测不同剂量冲洗液处理开放骨折创面后的细菌数,探讨伤口最佳冲洗液量。方法选择30例GustilloⅢ型开放骨折患者,冲洗前立刻进行创面细菌培养。分别在创面冲洗量达到1、2、3.5、4.5 L时采集伤口内组织,进行细菌学监测。结果冲洗1L时细菌的残留数较冲洗前明显减少(P<0.01);冲洗1 L时和2 L时的细菌数差异无统计学意义(P>0.05);冲洗3.5 L时较冲洗2 L时残留细菌数明显减少(P<0.05);冲洗3.5L时与冲洗4.5 L时细菌数差异无统计学意义(P>0.05)。结论 GustilloⅢ型开放骨折的冲洗液量在3.5 L左右时,既能达到了良好的冲洗效果,又能减少了冲洗带来的不良反应。Objective To study the optimal amount of flushing fluid by detecting the number of bacteria after different volumes of flushing fluid treatment of open fracture wounds. Methods 30 cases of Gustillo type Ⅲ open fracture patients were selected to perform bacterial culture before rinsing wound. When the patient＇ s wound in fluid volume reached 1 L,2 L,3. 5 L,4. 5 L,the wound tissue for bacteriological monitoring were collected. Results The wound＇s residual bacteria was reduced dramatically after rinseing 1 L of fluid compared with the amount before rinsing,the difference was statistically significant（ P〈0. 01）. There was no statistically significant difference between the number of bacteria when 1 L and 2 L washing were performed（ P〉0. 05）. The wound＇s residual bacteria was reduced distinctly after rinsing 3. 5 L fluid compared with the amount of rinsing 2 L,the difference was statistically significant（ P〈0. 05）. There was no statistically significant difference between the number of bacteria when 3. 5 L and4. 5 L washing were used（ P〉0. 05）. Conclusions The flushing fluid in about 3. 5 L for Gustillo type Ⅲ open fracture can achieve good effect of flushing,and reduce the adverse reactions caused by washing.

关 键 词：骨折 开放性 创面感染 冲洗 细菌 

分 类 号：R683[医药卫生—骨科学] R63[医药卫生—外科学]