截肢术后残端皮瓣坏死合并感染应用负压封闭引流的护理研究  

Application of vacuum sealing drainage in nursing care of amputation patients with postoperative skin flap necrosis complicated with infections

作　　者：李慧芬[1] 田静[1] 姜连英[1] 刘文慧[1] 马利平[1] 

机构地区：[1]吉林大学中日联谊医院骨科,吉林长春130033

出　　处：《中华医院感染学杂志》2015年第10期2297-2299,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81250016)

摘　　要：目的：探讨截肢术后残端皮瓣坏死合并感染应用负压封闭引流的护理方法，为临床应用提供参考依据。方法2012年3月－2014年2月骨科对15例截肢术后残端皮瓣坏死合并感染的患者应用负压封闭引流技术，护理上重点做好负压封闭引流护理、患肢疼痛护理、心理护理和营养支持。结果通过对负压封闭引流患者精心的治疗与护理，避免了因护理操作不当引起的再次感染，提高了护理的安全性；负压封闭引流5～7d后，揭除敷料时，有13例患者创面细菌培养呈阴性，无坏死组织残留，肉芽组织生长较好，行植皮术后愈合良好，2例患者更换二次负压封闭引流后，经过5～7d后，创面细菌培养呈阴性，无大量渗液集聚并可见新鲜肉芽组织，行植皮术后患者痊愈；15例患者无1例发生深部感染及骨髓炎等并发症。结论截肢术后残端皮瓣坏死合并感染患者应用负压封闭引流时，护理人员应密切观察引流情况，以保证有效引流，防止引流管道堵塞的发生，同时做好患肢疼痛护理、心理护理和营养支持，为二期植皮手术的顺利进行奠定良好基础，提高护理满意度。OBJECTIVE To explore the application of vacuum sealing drainage in nursing care of the amputation pa‐tients with postoperative skin flap necrosis complicated with infections so as to provide guidance for clinical appli‐cation .METHODS The vacuum sealing drainage technique was applied in 15 amputation patients with postoperative skin flap necrosis complicated with infections who were treated in the orthopedics department from Mar 2012 to Feb 2014 ,focusing on the nursing care including the vacuum sealing drainage care ,limb pain nursing ,psychologi‐cal nursing ,and nutrition support .RESULTS Through the meticulous treatment and nursing ,the recurrent infec‐tions due to nursing procedures were prevented and the nursing safety was improved .The wound specimens were cultured negative in 13 patients when the dressing were removed after the vacuum sealing drainage was carried out for 5 to 7 days ,no necrotic tissues remained ,and granulation tissues grew well ,and the patients got good postop‐erative healing after skin grafting .The wound specimens were cultured negative in 2 patients after the second vacu‐um sealing drainage was performed for 5 to 7 days ,without large volume of exdudates gathered ,the newly grown granulation tissues visible ,and the patients were cured after the skin grafting .The complications such as deep in‐fections and osteomyelitis did not occur in any of the 15 patients .CONCLUSION As the vacuum sealing drainage is applied for the amputation patients with postoperative skin flap necrosis patients complicated with infections ,it is necessary for the nursing staff to pay close attention to the condition of drainage to ensure the effective drainage and prevent the blockage of drainage tubes and carry out the limb pain nursing ,psychological nursing ,and nutri‐tion support so as to lay foundation for the phase Ⅱ skin grafting and improve the satisfaction with the nursing .

关 键 词：负压封闭引流 截肢术 感染 

分 类 号：R181.32[医药卫生—流行病学]