王婧楠，杨爱玲

(1.浙江中医药大学护理学院，浙江 杭州 310053; 2.宁波市第二医院，浙江 宁波 315000)

·基础与临床研究·

洗必泰在骨科术后感染伤口VSD冲洗引流中的应用

王婧楠1,2，杨爱玲2@

(1.浙江中医药大学护理学院，浙江 杭州 310053; 2.宁波市第二医院，浙江 宁波 315000)

目的：比较负压封闭引流(VSD)治疗骨科术后感染创面时应用生理盐水冲洗与生理盐水联合洗必泰冲洗2种方法的效果。方法2013年3月至2015年3月，共收集骨科术后感染创面应用VSD治疗的患者56例，其中28例VSD患者使用生理盐水冲洗(对照组)，28例VSD患者使用洗必泰联合生理盐水冲洗(观察组)，比较2组患者创面的细菌培养结果阴性例数及需二次清创手术的例数。结果生理盐水联合洗必泰冲洗方法在研究指标上均优于生理盐水冲洗方法(P<0.05)，且创面愈合疗效满意，并减少了二次手术的机率。结论骨科术后感染创面的治疗，应用VSD覆盖同时洗必泰和生理盐水联合冲洗创面，在感染的控制及创面的愈合方面，收到良好的效果。

感染伤口；VSD；洗必泰

Abstract:[Objective]To compare the clinic effects of washing orthopaedic postoperative infected wounds which treated with vacuum sealing drainage technology(VSD) between using saline solution and chlorhexidine plus saline solution. [Method] From March 2013 to March 2015, 56 orthopaedic postoperative patients with infected wounds whom treated with VSD technology were collected. Among them, 28 patients’ wounds were washing with saline solution (as control group), others were washing with chlorhexidine plus saline solution (as experimental group).Then compare these two groups with their bacterial culture results of wound negative cases, and cases which need secondary debridement surgery. [Result] In the experimental group, the wounds washed using chlorhexidine plus saline solution had a good result compare with the control group(P<0.05). And in the experimental group, patients wounds healed better than the control group, the ratio of secondary debridement surgery was reduced. [Conclusion] Orthopaedic postoperative patients with infected wounds, treated by VSD combining washing the wounds with chlorhexidine plus saline solution, had better effectson infection controlling and wounds healing.

Keywords: infected wounds; vacuum sealing drainage technology (VSD);chlorhexidine

交通事故及工伤所致的高能量损伤，往往会使患肢呈感染开放性外伤，临床治疗很棘手。负压封闭引流(Vacuum Sealing Drainage, VSD)技术能促进毛细血管基底膜恢复完整，降低血管通透性，减少组织水肿，刺激肉芽组织生长，缩小创面，成为治疗创面皮肤缺损、控制创面感染的良好技术[1]，并在临床一些科室得到应用和发展。VSD常规应用生理盐水不间断低流量冲洗，是为了避免管腔堵塞[2]。本研究采用生理盐水联合洗必泰冲洗与单纯生理盐水冲洗2种方法治疗骨科术后感染，观察比较疗效。

1 对象与方法

1.1 对象

2013年3月至2015年3月，使用VSD治疗感染创面的患者56例，其中车祸伤15例，机器绞伤12例，外院转入29例；外伤部位：上肢15例，单侧下肢28例，双下肢13例；……