慢性创面感染的病原学特点及持续灌洗负压封闭引流局部治疗的效果  

Etiological characteristics of chronic wound infection and the effect of local treatment with continuous lavage and vacuum sealing drainage

作　　者：强华 柴宝军 QIANG Hua;CHAI Bao-jun(Orthopeadic Surgery Department,Shaanxi Rongfu First Military Hospital,Baoji 721300,China)

机构地区：[1]陕西省荣复军人第一医院骨外科

出　　处：《临床医学研究与实践》2019年第20期44-45,共2页Clinical Research and Practice

摘　　要：目的探讨慢性创面感染的病原学特点及持续灌洗负压封闭引流(VSD)局部治疗的效果。方法分析在我院诊治的17例慢性创面感染患者创面感染致病菌特点,并探究持续灌洗VSD治疗的效果。结果17例患者创面组织、分泌物共培养出致病菌22株,1例患者创面感染致病菌培养为阴性。22株致病菌中,革兰氏阴性菌13株(59.09%),革兰氏阳性菌9株(40.91%)。革兰氏阴性菌以铜绿假单胞菌、大肠杆菌为主,革兰氏阳性菌以金黄色葡萄球菌为主。VSD持续治疗7d后,将VSD材料取出,8例患者创面经植皮后愈合,8例患者创面直接缝合后愈合,1例患者每5~7d更换VSD材料1次,连续更换治疗7次后创面新鲜肉芽组织形成,创面腔面变浅,转为普通换药治疗,7d后愈合。结论慢性创面患者感染致病菌以铜绿假单胞菌、大肠杆菌、金黄色葡萄球菌为主,持续灌洗VSD辅助治疗慢性创面的价值显著。Objective To study the etiological characteristics of chronic wound infection and the effect of local treatment with continuous lavage and vacuum sealing drainage(VSD).Methods The characteristics of pathogenic bacteria of wound infection in 17 patients with chronic wound infection treated in our hospital were analyzed,and the effect of continuous lavage and VSD was explored.Results Twenty-two strains of pathogenic bacteria were cultured from wound tissues and secretions of 17 patients,pathogenic bacteria culture of wound infection in a patient was negative.Among 22 strains of pathogenic bacteria,13 strains of Gram-negative bacteria(59.09%)and 9 strains of Gram-positive bacteria(40.91%)were isolated.Pseudomonas aeruginosa and Escherichia coli were the dominant Gram-negative bacteria.Staphylococcus aureus was the dominant Gram-positive bacteria.After 7 days of continuous VSD treatment,the VSD materials were taken out,wounds healed after skin grafting in 8 patients,and wounds healed after direct suture in 8 patients;VSD materials were replaced once every 5-7 days in 1 patient,with 7 times in a row,then fresh granulation tissue was formed on the wound surface,wound cavity became shallow,and patients were turned to general dressing change treatment,then wounds healed after 7 days.Conclusion Pseudomonas aeruginosa,Escherichia coli and Staphylococcus aureus are the main pathogenic bacteria in chronic wound patients.Continuous lavage and VSD is of great value in treating chronic wounds.

关 键 词：慢性创面感染 病原学特点 持续灌洗负压封闭引流 

分 类 号：R64[医药卫生—外科学]