负压封闭引流对Gustilo IIIB型和IIIC型开放性骨折伤口愈合的价值。
Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures.
作者信息
Fang Bo, Wang Yong-Sheng, Li Wei, Ying Kai, Zong Gang
机构信息
Department of Trauma Surgery, The Second People's Hospital of Dalian, Dalian 116019, Liaoning Province, China.
出版信息
World J Clin Cases. 2024 Jul 16;12(20):4199-4205. doi: 10.12998/wjcc.v12.i20.4199.
BACKGROUND
Gustilo III fractures have a high incidence and are difficult to treat. Patients often experience difficulty in wound healing. Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.
AIM
To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.
METHODS
Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People's Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects. They were divided into a study group ( = 40, healed with negative pressure closed drainage) and a control group ( = 40, healed with conventional dressing changes) according to the variation in the healing they received. The efficacy of the clinical interventions, the variations in the regression indicators (time to wound healing, time to fracture healing, time to hospitalization), and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.
RESULTS
The total effective rate of patients among the study group was 95.00% (38/40), which was notably higher than 75.00% (30/40) among the control group ( < 0.05). The wound healing time, fracture healing time, and hospital stay of the patients in the study group was shorter than the control group ( < 0.05). After the intervention, the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group ( < 0.05).
CONCLUSION
Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury. It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients.
背景
GustiloⅢ型骨折发病率高且治疗困难。患者伤口愈合常存在困难。负压引流技术有助于缩短伤口愈合时间，对改善患者预后具有积极价值。
目的
探讨封闭负压引流技术在GustiloⅢB和ⅢC型开放性骨折伤口愈合中的临床价值。
方法
选取2019年3月至2021年12月在大连市第二人民医院接受治疗的80例伴有皮肤及软组织损伤的GustiloⅢB和ⅢC型开放性骨折患者作为研究对象。根据接受的愈合方式不同分为研究组（n = 40，采用封闭负压引流愈合）和对照组（n = 40，采用传统换药愈合）。干预1-3个月后比较临床干预疗效、回归指标变化（伤口愈合时间、骨折愈合时间、住院时间）以及细菌伤口的转归和愈合情况。
结果
研究组患者总有效率为95.00%（38/40），显著高于对照组的75.00%（30/40）（P<0.05）。研究组患者的伤口愈合时间、骨折愈合时间和住院时间均短于对照组（P<0.05）。干预后，研究组患者伤口部位细菌培养阴性率和伤口愈合率较对照组升高（P<0.05）。
结论
封闭负压引流技术对伴有皮肤及软组织损伤的GustiloⅢB和ⅢC型开放性骨折患者具有良好的治疗效果。它可显著提高伤口愈合率和伤口表面细菌阴性率，有助于加快患者的康复进程。
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