一期缝合与持续封闭负压引流后延期缝合对儿童犬咬伤患者瘢痕及感染的影响  

Effect of primary suture and delayed suture after vacuum sealing drainage on scar and infection in children with canine bite wounds

作　　者：王烽[1] 王旭东[1] 黄立嵩 WANG Feng;WANG Xu-dong;HUANG Li-song(Aerospace Center Hospital,Beijing 100049,China)

机构地区：[1]航天中心医院,北京100049

出　　处：《中国临床医生杂志》2021年第8期914-916,共3页Chinese Journal For Clinicians

基　　金：中国航天科工医疗卫生科研项目(2019-LCYL-014)。

摘　　要：目的对比一期缝合与持续封闭负压引流技术(vacuum sealing drainage,VSD)后延期缝合对儿童犬咬伤患者瘢痕及感染的影响。方法选择2015年10月至2020年9月航天中心医院急诊科收治的儿童犬咬伤患者62例,按缝合方式分为一期缝合组和VSD延期缝合组,每组各31例。予以常规清创、免疫及抗感染治疗后,一期缝合组采用常规方法处理伤口,VSD延期缝合组患者24h内行创面负压封闭引流治疗,比较分析两组的感染发生率,瘢痕形成情况根据温哥华瘢痕评定量表(vancouver scar scale,VSS)进行评定。结果一期缝合组出现伤口感染6例(19.3%),VSD延期缝合组出现1例(3.2%),VSD延期缝合组的伤口感染发生率低于一期缝合组,差异有显著性(χ^(2)=4.026,P=0.045)。一期缝合组的患者VSS评分为(3.44±1.46)分,VSD延期缝合组为(1.97±0.87)分,VSD延期缝合组低于一期缝合组,差异有显著性(t=4.874,P=0.000)。结论对儿童犬咬伤患者应用负压封闭引流延期缝合可降低感染发生率,同时减少术后瘢痕的形成。Objective To compare the effects of primary suture and vacuum sealing drainage(VSD)followed by delayed suture on scars and infections in children with canine bite wounds.Method A total of 62 children with canine bite wounds who were admitted to the emergency department of the Aerospace Center Hospital from October 2015 to September 2020 were selected.They were divided into primary suture group and VSD delayed suture group according to the suture method,with 31 cases in each group.After routine washing the wound,immunization and anti-infection treatments,the primary suture group used conventional methods to treat the wound,and the VSD delayed suture group received negative pressure wound drainage treatment within 24 hours.The incidence of infection in the two groups was compared and analyzed.The scar formation was based on Vancouver Scar Rating Scale(VSS)for assessment.Result There were 6 cases(19.3%)of wound infection in the primary suture group and 1 case(3.2%)in the VSD delayed suture group.The incidence of wound infection in the VSD delayed suture group was lower than that of the first-stage suture group.The difference was significant(χ^(2)=4.026,P=0.045).The VSS score of patients in the primary suture group was 3.44±1.46,the VSD delayed suture group was 1.97±0.87,and the VSD delayed suture group was lower than the primary suture group.The difference was significant(t=4.874,P=0.000).Conclusion The application of VSD and delayed suture to children with canine bite wounds can reduce the incidence of infection and reduce the formation of postoperative scars.

关 键 词：儿童 犬咬伤 负压封闭引流 延期缝合 

分 类 号：R184.3[医药卫生—流行病学]