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负压伤口治疗对复杂难治性伤口治疗效果的观察

[Observation on the therapeutic effects of negative-pressure wound therapy on the treatment of complicated and refractory wounds].

作者信息

HU Kai-xuan, ZHANG Hong-wei, ZHOU Fang, YAO Gang, SHI Jing-ping, CHENG Zhi, WANG Li-fu, HOU Zuo-qiong

机构信息

Department of Plastic Surgery and Burns, First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2009 Aug;25(4):249-52.

PMID:19951540
Abstract

OBJECTIVE

To study the effects of negative-pressure wound therapy (NPWT) on the treatment of complicated and refractory wounds.

METHODS

Sixty-seven patients with complicated or refractory wounds admitted to our hospital from September 2005 to November 2008 were randomly divided into NPWT group (n = 35) and conventional treatment (CT) group (n = 32). Wounds of patients in NPWT group were treated with interrupted suction under a pressure of -16.63 kPa for 24 hs, or continuous suction under a pressure of -10.64 kPa for 24 hs. Wounds of patients in CT group were covered with petrolatum gauze overlaid with isotonic saline gauze and dry gauze. Duration of treatment, times of operation, treatment cost, and the process of healing were compared between two groups.

RESULTS

The duration of treatment, treatment cost and times of operation of patients in NPWT group were obviously less or fewer than those of CT group (P < 0.05). Wounds of patients in NPWT group were mainly healed by themselves (40.0%) or healed after free skin grafting (40.0%). While wounds in patients in CT group healed mainly after tissue flap transplantation (66.7%) or free skin grafting (23.3%).

CONCLUSIONS

Compared with CT, NPWT can shorten the length of hospital stay, reduce operation frequency and treatment cost, and it is easier to carry out in the surgery of treating complicated and refractory wounds, which is worth generalization.

摘要

目的

研究负压伤口治疗(NPWT)对复杂难愈伤口的治疗效果。

方法

将2005年9月至2008年11月我院收治的67例复杂或难愈伤口患者随机分为NPWT组(n = 35)和传统治疗(CT)组(n = 32)。NPWT组患者的伤口采用-16.63 kPa压力间断吸引24小时,或-10.64 kPa压力持续吸引24小时。CT组患者的伤口用凡士林纱布覆盖,其上再覆盖等渗盐水纱布和干纱布。比较两组的治疗时间、手术次数、治疗费用及愈合过程。

结果

NPWT组患者的治疗时间、治疗费用和手术次数明显少于CT组(P < 0.05)。NPWT组患者的伤口主要自行愈合(40.0%)或在游离植皮后愈合(40.0%)。而CT组患者的伤口主要在组织瓣移植后愈合(66.7%)或游离植皮后愈合(23.3%)。

结论

与传统治疗相比,NPWT可缩短住院时间,减少手术频率和治疗费用,且在复杂难愈伤口的手术治疗中更易于实施,值得推广。

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