论文部分内容阅读
目的总结使用负压封闭引流技术治疗胸壁伤口感染的初步经验及体会。方法回顾性分析2011年7月至2013年10月四川大学华西医院16例开胸手术后发生胸壁切口感染患者的临床资料,其中男13例,女3例;年龄(50.8±6.7)岁。手术种类包括脓胸廓清术、肺叶切除术、纵隔肿瘤切除术和食管癌根治术。通过应用负压封闭引流技术,进行伤口的持续负压吸引治疗,观察治疗效果,积累初步经验。结果经过持续负压引流,16例患者中有3例未达到二期缝合的标准(负压封闭引流愈合标准),其中2例由于患者耐受差,不愿继续使用,转为每日更换敷料;1例由于伤口感染控制不佳,感染范围增加,更换为每日换药治疗。总的负压封闭引流治疗愈合率为81.2%(13/16)。6例(37.5%)患者为多次安置负压封闭引流。累计保留负压封闭引流时间为4~24 d,中位时间9 d。治疗过程中无负压封闭引流相关不良事件发生。随访11例,随访时间2~8个月,失访5例。11例患者中,1例出现轻微的伤口异物反应(皮下缝线),经拆除皮下缝线后治愈;其余患者伤口均愈合良好,未见感染复发。结论负压封闭引流技术治疗胸外科手术后胸壁切口感染安全、可行、有效,患者耐受好,具有较高的临床应用价值。而通过初期的使用经验总结,有利于我们拓展负压封闭引流技术的应用领域,整体提高胸外科手术后伤口感染的治疗效果。
Objective To summarize the experience and experience of using negative pressure closed drainage technique to treat chest wall wound infection. Methods The clinical data of 16 patients with thoracic incision infection after thoracotomy in Huaxi Hospital of Sichuan University from July 2011 to October 2013 were retrospectively analyzed. There were 13 males and 3 females with a mean age of 50.8 ± 6.7 years. Surgical categories include empyema, lobectomy, mediastinal tumor resection and esophageal cancer radical mastectomy. Through the application of negative pressure drainage technology, continuous suction of the wound to treat, observe the therapeutic effect, the accumulation of initial experience. Results After continuous negative pressure drainage, 3 out of 16 patients did not meet the standard of secondary suture (negative pressure closed drainage and healing standard), and 2 of them were reluctant to continue to use due to poor patient tolerance. ; 1 case due to poor wound infection control, increased infection range, replaced by daily dressing change. The total negative pressure closed drainage treatment healing rate was 81.2% (13/16). Six patients (37.5%) had multiple placement of negative pressure drainage. Accumulation of negative pressure closed drainage time of 4 ~ 24 d, the median time 9 d. During the treatment of negative pressure closed drainage related adverse events. Eleven patients were followed up for 2 to 8 months and 5 patients were lost to follow-up. Of the 11 patients, 1 showed a slight foreign body wound reaction (subcutaneous suture), which was cured after the subcutaneous suture was removed. The rest of the wounds healed well and no recurrence of infection was found. Conclusion The negative pressure closed drainage technique is safe, feasible and effective in treating thoracic incision infection after thoracic surgery. It has good clinical application value. Through the initial use of experience summary, help us to expand the application of vacuum occlusion drainage technology, the overall improvement of thoracic surgery wound infection after treatment.