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[目的]观察自制实用闭式负压装置治疗慢性难愈合创面的临床效果。[方法]61例难愈合创面患者随机分为观察组和对照组。观察组使用自制闭式负压引流装置处理创面,对照组使用传统方法换药。比较伤口形态变化、细菌培养结果和植皮成活率的差异。皮肤缺损较大的创面,经过伤口床准备,行邮票法植皮。比较均次成活率、创面愈合时间和换药次数及费用的差异。[结果]观察组治疗1周后,创面细菌培养菌落数(21.00±5.43)CFU/cm2,植皮成活率95%,平均创面愈合时间18.4 d。对照组创面细菌培养菌落数(57.00±12.37)CFU/cm2,植皮成活率82%,创面愈合时间23.7 d。两组比较,差异有统计学意义(P<0.05)。观察组换药均次6次,换药费用972.66元。对照组换药11次,换药费用1 576.31元。差异有统计学意义(P<0.05)。[结论]自制闭式负压引流装置替代传统换药方法用于治疗慢性难愈合创面,具有明显的技术优势。具有操作简单、取材方便、疗效肯定、患者经济负担小等优点。
[Objective] To observe the clinical effect of self-made and practical closed negative pressure device in the treatment of chronic refractory wounds. [Method] 61 patients with refractory wounds were randomly divided into observation group and control group. The observation group used a self-made closed negative pressure drainage device to treat wounds, while the control group used traditional methods to dressing. The changes of wound morphology, bacterial culture results and skin graft survival rates were compared. The skin defect larger wound, after wound bed preparation, line stamp law skin graft. Compare the average survival rate, wound healing time and the number of dressing changes and cost differences. [Results] After 1 week of treatment, the number of bacterial culture colonies (21.00 ± 5.43) CFU / cm2 in the observation group was 95%, and the average skin wound healing time was 18.4 days. The number of bacterial culture colonies in the control group was 57.00 ± 12.37 CFU / cm2, the skin graft survival rate was 82% and the wound healing time was 23.7 days. The difference between the two groups was statistically significant (P <0.05). Observation group dressing 6 times, dressing costs 972.66 yuan. The control group dressing 11 times, dressing costs 1 576.31 yuan. The difference was statistically significant (P <0.05). [Conclusion] Self-made closed negative pressure drainage device has the obvious technical advantages to replace the traditional dressing method for treating chronic refractory wounds. Has the advantages of simple operation, easy access, positive curative effect, patients with small economic burden.