摘要
目的探讨负压封闭引流技术(VSD)不同负压对皮肤软组织严重损伤创面引流效果的影响,旨在为规范创面引流护理提供参考。方法将67例皮肤软组织严重损伤患者采用随机数字表法分为观察组(34例)和对照组(33例),两组彻底清创后,采用VSD敷料覆盖或填充创面,并行负压引流,观察组采用-0.06^-0.08MPa的负压引流,对照组采用-0.02^-0.04Mpa的负压引流。两组引流初期(引流48~72h)均用生理盐水持续冲洗,以后根据创面渗液情况停止冲洗或改为间断冲洗。结果观察组堵管发生率、创面感染率显著低于对照组,第1周平均引流量显著多于对照组,创面清洁及愈合时间显著短于对照组(P<0.05,P<0.01)。结论对于皮肤软组织严重损伤创面行VSD引流,建议采用-0.06^-0.08MPa的负压,能降低堵管发生率、保持引流通畅,降低创面感染发生率,促进创面愈合。
Objective To analyze the drainage effects of vacuum sealing drainage（VSD） with different negative pressures on severe skin soft tissue wound and to provide reference for standardizing nursing measures for wound drainage. Methods A total of 67 patients with severe skin soft tissue injuries were randomly divided into two groups：the exprimental group of 34 patients and the control group of 33 patients. After radical debridement, the wound of all patients were covered or filled with VSD surgical dressing to maintain the closure of wound and given VSD at -0.06 to -0.08 MPa and -0.02 to -0.04 MPa for the exprimental group and control group respectively. At the beginning of drainage （48 to 72 hours）, the same normal saline （0. 9%） was used for two groups. After that, wound rinsing was stopped or discontinued according to the wound condition. Results The tube blocking rate and wound infection rate of the experimental group were significantly lower than the control group （P〈 0.05, P〈0.01）; the average drainage volume of the experimental group was far more than the control group in the first week. Moreover, the time of wound cleaning and healing of the experimental group was shorter than those of the control group （P〈0.05 ,P〈0.01）. Conclusion The method of using negative preseure between -0.06 to -0.08 MPa during VSD therapy can reduce the tube blocking rate as well as infection rate, and promote wound healing.
基金
四川省卫生厅科研基金课题(120081)
关键词
皮肤软组织损伤
创面
负压封闭引流技术
负压引流
护理
severe skin soft tissue injury wound
vacuum sealing drainage negative pressure drainage nursing care
