一期缝合联合脂质水胶敷料引流在颌面部犬咬伤治疗中的应用效果  

The Effect of Primary Suture Combined with Drainage of Lipidocolloid Dressing in Management of Maxillofacial Dog Bite Wounds

作　　者：张路 黄立嵩[2] ZHANG Lu;HUANG Li-song(Department of Burn and Plastic Surgery,Navy General Hospital of PLA,Beijing 100048,China)

机构地区：[1]海军总医院烧伤整形科,北京100048 [2]海军总医院急诊科,北京100048

出　　处：《中国现代手术学杂志》2018年第3期213-216,共4页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨一期缝合联合脂质水胶敷料引流在颌面部犬咬伤治疗中的应用效果。方法 2015年1月~2016年12月我院急诊外科收治360例颌面部犬咬伤患者,随机均分为两组:实验组180例,其中颧区49例,颊区38例,腮腺咬肌区41例,颏区24例,眶下区28例;对照组180例,其中颧区43例,颊区39例,腮腺咬肌区45例,颏区33例,眶下区20例。均伤口清创后均予以一期缝合,实验组采用脂质水胶敷料进行创口引流,对照组无引流。观察比较两组的创面感染率、愈合时间、有效率和瘢痕形成情况。结果实验组患者的伤口感染率及瘢痕形成VSS评分均明显低于对照组,愈合时间明显短于对照组,治疗7 d和14 d后总有效率显著高于对照组,差异均有统计学意义(P<0.05)。结论一期缝合颌面部犬咬伤创面治疗中应用脂质水胶敷料引流能够加速创面愈合,减少感染率和瘢痕的形成。Objective To explore the clinical efficacy of primary suture combined with lipidocolloid dressing drainage in management of maxillofacial dog bite wounds. Methods A total of 360 patients with maxillofacial dog bite wounds were divided into trial group and control group randomly with 180 cases for each, and treated with debridement and primary suture. The wounds of trial group were located in zygomatic region in 49 cases, buccal region in 38 cases, parotideomasseteric region in 41 cases, mental region in 24 cases and infraorbital region in 28 cases, and the wounds of control group were located in zygomatic region in 43 cases, buccal region in 39 cases, parotideomasseteric region in 45 cases, mental region in 33 cases and infraorbital region in 20 cases. The wounds were treated with lipidocolloid dressing to drain in trial group. The infection rate, healing time, effective rate and scar formation were compared between the two groups. Result The wound infection rate and VSS score of scar formation was lower, the wound healing time was shorter and the total effective rate of 7 d and 14 d after the surgery was higher in the trial group than those in the control group, and the differences were statistically （ P 〈0.05）. Conclusion The primary suture combined with lipidocolloid dressing drainage could promote the wound healing, reduce the infection rate and prevent the scar formation effectively for maxillofacial dog bite wounds.

关 键 词：上颌面部损伤 犬咬伤 一期缝合 脂质水胶敷料 引流术 

分 类 号：R622[医药卫生—整形外科]