ObjectiveTo explore the practical effect of standardized management path for inpatients with chronic and difficult-to-heal wounds.MethodsThe inpatients with chronic and difficult-to-heal wounds in People’s Hospital of Deyang City from July 2015 to June 2019 were collected. According to the random number table, the patients were divided into control group and intervention group. The control group were given routine management and the intervention group were given standardized management. Skin symptoms, Visual Analogue Scale (VAS), wound healing time, length of hospital stay, efficacy, complications, satisfaction and scar hyperplasia were recorded and compared.ResultsA total of 605 patients were included. There were 314 cases in the control group and 291 cases in the intervention group. Before treatment, there was no significant difference in skin symptom score or VAS score between the two groups (P>0.05); after treatment, the skin symptom scores and VAS scores of the two groups decreased (P<0.05), and the scores in the intervention group were lower than those in the control group (P<0.05). The wound healing time [(24.21±1.42) vs. (18.59±1.63) d; t=45.301, P<0.001] and length of hospital stay [(26.97±1.54) vs. (20.03±1.42) d; t=57.492, P<0.001] in the intervention group were shorter than those in the control group. All patients were followed up. The total effective rate (χ2=3.911, P=0.048) and satisfaction (χ2=4.340, P=0.037) of the intervention group were higher than those of the control group. The degree of scar hyperplasia (Z=4.913, P<0.001) and the incidence of complications (P=0.039) of the intervention group were also lower than those of the control group.ConclusionsThe standardized management of hospitalized patients can significantly shorten the chronic and difficult-to-heal wounds healing time, reduce the occurrence of complications, improve the patient’s satisfaction and prognosis. It is worthy of clinical application.
目的 探討可調節負壓引流技術結合植皮治療皮膚缺損伴感染創面的臨床效果及護理要點。 方法 對2008年5月－2011年5月收治的106例皮膚缺損伴感染創面患者，采用間歇負壓引流治療3～10 d，負壓值設為50～120 mm Hg（1 mm Hg=0.133 kPa），創面達到Ⅱ期植皮條件時，采用大張、網狀或郵票狀皮片覆蓋創面，繼續采用持續負壓引流治療3～12 d，負壓值設為50～60 mm Hg，同時進行患者心理和可調節負壓引流技術創面等護理。 結果 56例大張皮片植皮中，2例皮片出現0.5 cm×1 cm～0.8 cm×1.2 cm皮片壞死；21例郵票狀植皮者，1例出現皮片移動皺縮。除5例骨外露，先通過植皮創面縮小后行皮瓣轉移，101例創面愈合時間7～25 d，平均14 d，無因所植皮片未成活需再次植皮和因感染死亡或截肢。 結論 可調節負壓引流技術結合植皮治療皮膚缺損伴感染創面，可有效控制感染，減輕患者換藥痛苦，減少醫務人員換藥和護理工作量，加快植皮創面愈合，縮短創面治愈時間。
目的 觀察可調節負壓引流技術聯合局部氧療治療腹部切口感染創面的臨床效果。 方法 對2009年5月－2012年9月28例腹部切口感染創面患者使用可調節負壓引流技術聯合局部氧療治療，創口內填入負壓吸附墊，持續輸氧0.5～1 L/min，可調節負壓采用連續工作模式，使密閉創面保持60～120 mm Hg（1 mm Hg=0.133 kPa）的負壓狀態，3～7 d更換負壓吸附墊和引流管。 結果 28例切口創面感染得到控制。8例經一次治療創面愈合，15例經2～4次治療創面愈合，2例行Ⅱ期縫合，3例患者對貼膜過敏，治療一次后改為換藥治療。28例患者創面愈合時間4～28 d，平均14 d，隨訪1～18個月無切口裂開，7例有凹陷瘢痕，余瘢痕平整。 結論 可調節負壓引流技術聯合局部氧療治療腹部切口感染創面，具有操作簡便、安全可靠、療效明顯的優點，可加快創面愈合，縮短住院時間，提高切口的愈合質量，減輕患者痛苦及醫務人員的工作量。