Ma H D, Bai J, Du X J, Liu H D, Gao Y, Li J J, Liang W D, Cao L H, Qu J F
Department of Foot and Ankle, the Second Hospital of Tangshan City, Hebei 063000 , China.
Zhonghua Yi Xue Za Zhi. 2017 Jan 17;97(3):212-216. doi: 10.3760/cma.j.issn.0376-2491.2017.03.011.
To observe the clinical effect of vacuum sealing drainage (VSD) technique and simple dressing change in the treatment of delayed severe infection after calcaneal fracture surgery. From August 2008 to July 2015 , 73 patients with delayed severe infection were treated after calcaneal fractures 3 months in Department of Foot and Ankle, the Second Hospital of Tangshan City, according to the treatment methods are divided into vacuum sealing drainage group of 38 cases, 35 cases of simple dressing group.Two groups of patients after regular wound debridement debridement and sterilization after vacuum sealing drainage group received double wound VSD dressing group received postoperative dressing, two groups of patients with sensitive antibiotics for treatment.Two groups of patients according to the frequency of dressing change, wound healing time, bacterial clearance time and healing time were compared in stage Ⅱ during the perioperative period. Vacuum sealing drainage group: dressing: 7 times, the wound healing time was 27 days, bacterial culture negative for 8 days, the healing time of 13.5 days of perioperative period; treatment group: 34 times the number of dressing, wound healing time was 44 days, bacterial culture negative for 18 days, the healing time of 17 days of surgery period. Two groups of data were compared with the median, after the rank sum test, the difference was statistically significant ( values were -6.670, -5.529, -5.011, -3.227, <0.05). The vacuum sealing drainage group compared with conventional dressing group significantly reduced the number of dressing, wound healing time, healing time was significantly shortened bacterial clearance time and perioperative period Ⅱ. Double VSD is easy , safe and quick, short cure time, less pain, higher quality of late life advantages, compared with the traditional dressing treatment of calcaneal fractures of postoperative delayed severe infection, is a safe and effective method.
观察封闭式负压引流（VSD）技术与单纯换药在跟骨骨折术后严重感染延迟治疗中的临床效果。2008年8月至2015年7月，唐山市第二医院足踝科对73例跟骨骨折3个月后出现严重感染延迟治疗的患者，根据治疗方法分为封闭式负压引流组38例，单纯换药组35例。两组患者均常规进行伤口清创消毒后，封闭式负压引流组伤口予以双VSD敷料，单纯换药组术后予以换药，两组患者均应用敏感抗生素治疗。比较两组患者围手术期Ⅱ期换药次数、伤口愈合时间、细菌清除时间及愈合时间。封闭式负压引流组：换药7次，伤口愈合时间27天，细菌培养转阴8天，围手术期Ⅱ期愈合时间13.5天；单纯换药组：换药34次，伤口愈合时间44天，细菌培养转阴18天，围手术期Ⅱ期愈合时间17天。两组数据经中位数比较，秩和检验后，差异有统计学意义（值分别为-6.670、-5.529、-5.011、-3.227，P<0.05）。封闭式负压引流组与传统换药组比较，显著减少了换药次数，缩短了伤口愈合时间、细菌清除时间及围手术期Ⅱ期愈合时间。双VSD具有操作简便、安全快捷、治愈时间短、痛苦小、后期生活质量高等优点，与传统换药治疗跟骨骨折术后严重感染延迟治疗相比，是一种安全有效的方法。
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