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[自制引流管在33例患者软组织不同层次负压伤口治疗中的临床应用]

[Clinical application of self-made drainage tubes in different layers of soft tissue for negative-pressure wound therapy in 33 patients].

作者信息

Zhao Y H, Xia C D, Shao G Y, Feng Y Y, Xiong W, Shen Y M, Xu L L, Huang W Q, Deng H T, Yuan D L

机构信息

Department of Burns and Plastic Surgery, the Affiliated Jiangyin Hospital, Medical College of Southeast University, Jiangyin 214400, China.

Department of Burns, Zhengzhou First People's Hospital, Zhengzhou 450004, China.

出版信息

Zhonghua Shao Shang Za Zhi. 2020 Jun 20;36(6):493-496. doi: 10.3760/cma.j.cn501120-20190327-00142.

Abstract

From January 2014 to June 2018, 28 patients with different types of deep soft tissue injury or infection were admitted to the Affiliated Jiangyin Hospital of Medical College of Southeast University; 5 patients were admitted to the Zhengzhou First People's Hospital. There were 24 males and 9 females, aged 18-89 (40±20) years. Disposable suction tubes with holes cut on side walls were used as self-made drainage tubes. The authors placed the self-made drainage tubes on different deep soft tissue layers and wound surfaces after debridement. The effective drainage sections of the wound surface drainage tubes were wrapped with silver ion antimicrobial functional active dressings. Bio-permeable membrane was used to close the operative area. The drainage tubes in the deep layer of wound and wound surface were connected in parallel by a tee and connected to wall-hanging medical negative-pressure suction device to conduct negative-pressure wound treatment at -20.0 to -10.6 kPa. The deep drainage tubes were usually removed or changed 4 or 5 days after surgery.The drainage tubes in the wound surface were synchronously replaced when removing or replacing he drainage tubes in the deep layer of wound. On 4 to 15 days after surgery, the deep drainage tubes were removed. On 8 to 25 days after surgery, the wound surface drainage tubes were removed. Then the treatment was changed to a conventional dressing change until the wounds were completely healed or the wound bed was ready for skin grafts or tissue flaps. The indwelling time of deep drainage tubes in this group of patients was (6.2±2.8) days, and the indwelling time of wound surface drainage tubes was (12.0±3.0) days. The wound healing time was (22±5) days, the hospital stay time was (29±7) days, and wound bacteria were reduced from 6 species and 11 strains before treatment to 3 species and 4 strains after treatment. No adverse events such as wound bleeding, irritative pain, and chronic sinus occurred during treatment. Twenty-three patients were followed up for 13 to 28 months, no treatment-related complications were observed.

摘要

2014年1月至2018年6月,东南大学医学院附属江阴医院收治了28例不同类型的深部软组织损伤或感染患者;郑州市第一人民医院收治了5例。患者共24例男性和9例女性,年龄18 - 89岁(40±20岁)。将侧壁有孔的一次性吸引管用作自制引流管。作者在清创后将自制引流管放置于不同的深部软组织层和创面。创面引流管的有效引流段用银离子抗菌功能性活性敷料包裹。采用生物渗透膜封闭手术区域。创面深层和创面的引流管用三通管并联连接,并连接到壁挂式医用负压吸引装置,在-20.0至-10.6 kPa进行负压伤口治疗。深部引流管通常在术后4或5天拔除或更换。在拔除或更换创面深层引流管时同步更换创面引流管。术后4至15天拔除深部引流管。术后8至25天拔除创面引流管。然后将治疗改为常规换药,直至伤口完全愈合或伤口床适合植皮或组织瓣移植。该组患者深部引流管留置时间为(6.2±2.8)天,创面引流管留置时间为(12.0±3.0)天。伤口愈合时间为(22±5)天,住院时间为(29±7)天,伤口细菌从治疗前的6种11株减少至治疗后的3种4株。治疗期间未发生伤口出血、刺激性疼痛和慢性窦道等不良事件。23例患者随访13至28个月,未观察到与治疗相关的并发症。

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