超声波清创联合VSD在慢性创面中的应用

发布时间：2018-11-28 16:49

【摘要】：目的: 观察、评价超声波清创联合负压封闭引流（Vacuum sealing drainage,VSD）促进慢性创面愈合的治疗效果；寻找一种促进慢性创面快速愈合的新方法。方法：选取自2012年9月至2014年1月郑州大学第一附属医院急诊外科收住院、伴有慢性创面的病人434例作为研究对象，随机分为超声波清创组206例与常规清创组228例，超声波清创组病人以多功能超声波清创仪清创后以VSD材料覆盖创面，以后每7天清创1次并更换VSD材料，引流管被堵塞，封闭负压失效时及时更换，，直至创面愈合或者创面肉芽新鲜、以缝合、植皮或者皮瓣修复消灭创面结束；常规清创组采用常规清创方法，即使用手术刀或者剪刀直接切除痂皮及坏死组织，创面以双氧水及生理盐水反复冲洗，盐水纱布刷洗，至肉眼观察创面肉芽红润为止，清创后同样以VSD材料覆盖，每7天清创1次并更换VSD材料，引流管被堵塞，封闭负压失效时及时更换，直至创面愈合或者创面肉芽新鲜，以缝合、植皮或者皮瓣修复消灭创面结束。观察、评价两组创面的细菌清除率，创面愈合时间，手术时间，住院天数等指标。结果: 超声波清创组在提高细菌清除率、缩短手术时间、加快创面愈合时间、缩短住院天数等方面均优于常规清创组（P0.05）。结论: 超声波清创联合VSD技术应用于慢性创面使两者优势叠加，能够提高清创效率，改善清创效果，加速慢性创面的愈合，是一种较好的联合治疗慢性创面的新方法，值得推广应用。
[Abstract]:Objective: to observe and evaluate the therapeutic effect of ultrasonic debridement combined with negative pressure sealing drainage (Vacuum sealing drainage,VSD) on chronic wound healing and to find a new method to promote the rapid healing of chronic wound. Methods: from September 2012 to January 2014, 434 patients with chronic wound were randomly divided into ultrasonic debridement group (206 cases) and routine debridement group (228 cases). The patients in the ultrasonic debridement group were covered with VSD material after debridement with multifunctional ultrasonic debridement instrument. After that, the wound was debrided once every 7 days and the VSD material was replaced, the drainage tube was blocked, and the sealing negative pressure failed to be replaced in time. Until the wound is healed or the granulation of the wound is fresh, the wound ends with suture, skin grafting or flap repair. In the conventional debridement group, the scab and necrotic tissue were directly removed with scalpel or scissors, the wound was washed repeatedly with hydrogen peroxide and normal saline, the salt water gauze was brushed, and the granulation was observed with naked eyes. After debridement, the wound was also covered with VSD material, and the VSD material was replaced once every 7 days. The drainage tube was blocked. When the sealing negative pressure failed, it was replaced in time until the wound healed or the granulation of the wound was fresh to suture. End of skin graft or skin flap repair and exterminate wound. The bacterial clearance rate, wound healing time, operation time and hospital stay were observed and evaluated. Results: the ultrasonic debridement group was superior to the conventional debridement group in improving the bacterial clearance rate, shortening the operation time, accelerating the wound healing time and shortening the hospitalization days (P0.05). Conclusion: ultrasonic debridement combined with VSD can improve the efficiency of debridement, improve the effect of debridement and accelerate the healing of chronic wounds. It is a new method of combined treatment of chronic wounds. It is worth popularizing and applying.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R641

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