自制封閉式負(fù)壓引流裝置在骨科術(shù)后延遲愈合傷口中的應(yīng)用

王曉芹+鄭雨函+張芹

摘要：目的 觀察自制封閉式負(fù)壓引流裝置在骨科術(shù)后延遲愈合傷口中的應(yīng)用效果。方法 選取我科2014年9月～2016年9月術(shù)后延遲愈合傷口患者42例，隨機(jī)分為對照組和觀察組，對照組采用傳統(tǒng)外科換藥方法，觀察組采用自制封閉式引流裝置處理傷口，兩組患者在年齡、性別、傷口面積、傷口部位、傷口深度方面，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。結(jié)果 兩組患者傷口均Ⅱ期愈合，觀察組傷口愈合時(shí)間、換藥次數(shù)及換藥費(fèi)用少于對照組，差異具有顯著性，有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 自制封閉式負(fù)壓引流裝置在骨科術(shù)后延遲愈合傷口應(yīng)用中效果顯著，操作簡單、經(jīng)濟(jì)實(shí)用，值得應(yīng)用與推廣。

關(guān)鍵詞：延遲愈合傷口；負(fù)壓引流；護(hù)理

Abstract：Objective To observe the effect of self-made closed negative pressure drainage device in delayed wound healing after orthopedic surgery. Methods 42 patients with delayed wound healing were enrolled in this study from September 2014 to September 2016.They were randomly divided into control group and observation group.The control group used the traditional surgical treatment methods，observation group were treated with self-made closed drainage device for wound treatment，the two groups in age，gender，wound area，wound site，wound depth，there was no statistically significant difference （P>0.05），comparable.Results The wounds healed by second intention in the two groups.The wound healing time，the number of dressing change and the cost of dressing change in the observation group were less than those in the control group，the difference was significant，with statistical significance（P<0.05）.Conclusion Self-made closed negative pressure drainage device is effective in the application of delayed wound healing after orthopedic surgery.It is simple，economical and practical.It is worthy of application and popularization.

Key words：Delayed healing wounds；Negative pressure drainage；Nursing

術(shù)后傷口延遲愈合是骨科術(shù)后常見并發(fā)癥之一，導(dǎo)致傷口延遲愈合的因素有傷口感染、皮下積液、脂肪液化及患者營養(yǎng)不良等。自從1992年德國FIeischman博士首創(chuàng)封閉式負(fù)壓引流技術(shù)[1]，1994年裘華德教授首次將VSD技術(shù)引入國內(nèi)[2]，用于治療四肢軟組織創(chuàng)面后，其應(yīng)用效果很快得到肯定。但在臨床應(yīng)用中，由于國內(nèi)外生產(chǎn)廠家生產(chǎn)的成套VSD裝置價(jià)格昂貴，每套價(jià)格在2500～3000元；加之VSD技術(shù)存在容易出現(xiàn)堵管及吸引材料硬化等缺點(diǎn)，影響治療效果[3]，增加了患者的經(jīng)濟(jì)負(fù)擔(dān)，因而限制了其在臨床的廣泛應(yīng)用。為此，我科從2014年3月起對18例骨科術(shù)后傷口延遲愈合患者采用自制VSD裝置對其進(jìn)行創(chuàng)面治療，取得了滿意效果。現(xiàn)報(bào)道如下。

1 資料與方法

1.1一般資料 選取我院骨科2014年3月～2016年3月術(shù)后傷口延遲愈合的患者42例。其中男31例，女11例。年齡16～65歲。傷口部位：背部4例，腹股溝8例，膝部8例，小腿22例。傷……