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Objective@#To explore the clinical application value of closed negative pressure drainage technique in the treatment of external foot injury.@*Methods@#Sixty-eight patients with hand and foot trauma admitted to the Enze Hospital of Taizhou Enze Medical Center (Group) from November 2017 to November 2018 were randomly divided into the control group and the observation group according to the digital table, with 34 cases in each group.The control group underwent routine skin grafting.The observation group underwent closed vacuum drainage.The therapeutic effects, wound healing rate and clinical observation indicators were compared between the two groups.@*Results@#The total effective rate (88.24%) and the overall wound healing rate (100.00%) in the observation group were significantly higher than those in the control group (64.71%, 79.41%) (χ2=5.231, 7.803, P=0.022, 0.005). The operation time[(5.92±1.02)h], wound healing time[(16.65±8.01)d] and hospitalization time[(31.42±13.05)d] in the observation group were significantly shorter than those in the control group[(8.33±1.65)h, (23.51±12.12)d, (46.35±18.89)d](t=7.244, 2.753, 3.792, P=0.001, 0.008, 0.001).@*Conclusion@#Application of closed negative pressure drainage technique in hand and foot trauma surgery can effectively improve clinical efficacy, accelerate the healing speed of wounds, and reduce the operation time and hospitalization time of patients.It is worthy of promotion.
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Objective To investigate the efficacy of flexor muscle disconnection combined with myocutaneous flap in the treatment of pressure ulcer in patients of ankylosing posture.Methods A retrospective case series study was conducted to analyze 15 patients with pressure ulcer at different body parts due to ankylosing posture after paraplegia admitted to the First Affiliated Hospital of Jinan University from January 2012 to July 2017.There were 10 males and five females,aged 40-78 years,with an average age of 68 years.The pressure ulcer ranged from 3 cm× 3 cm to 15 cm × 11 cm.The pressure ulcers were distributed at sacrococcygeal region in eight patients,macro-rotator in four,and ischial nodules in three.According to the size and position of pressure ulcer,different musculocutaneous flaps were selected,and high selective decompression of hip flexion and knee flexion was performed to ensure the tension free suture of the wound.After the operation,the negative pressure closed drainage (VSD) was given to maintain a proper posture for wound healing.The stitches were removed after the wound healed.The wound healing,pressure ulcer recurrence,flap texture,flap color,and donor site were observed,and patient satisfaction were also surveyed.Results All patients were followed up for 12-36 months,average 24 months.The pressure ulcer was healed in 12 patients after the first repair operation.In two nonunion cases,the unrelieved knee flexion and knee muscles led to high muscular tension and stiff joint,causing strong resistance during limb movement and strong flexor reflex.Two patients were healed after twice operation.In one patient,the incision was torn by the excessive flexion tension due to improper body position caused by the passive movement of the limb after operation,and the wound was healed after twice operation.All muscle flaps covered the wound and survived well,and the wounds were completely closed and healed with good shape,texture as well as elastic recovery.After the suture was removed18 days after surgery,the patients were discharged satisfactorily.The patients received conventional pressure ulcer care,and no new pressure ulcer was reported during the follow-up.The flap donor site was healed well after autologous skin repair.Conclusion For pressure ulcer in patients of ankylosing posture,flexor muscle disconnection combined with myocutaneous flap has notable effects in reducing tension and can accelerate wound healing and improve healing rate.
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Objective To explore the clinical effect of patients of oral and maxillofacial space infection treated with improved closed negative pressure drainage combined with hyperbaric oxygen, and the possibility of using this method to decrease the hospital expenses. Methods 156 patients with oral and maxillofacial space infection were divided into control group, closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group by random number table. 52 patients in each group. The granulation tissue growth time, the healing of wound, clinical effect of the 8thday, hospitalization days, wound healing time, antibiotic cost, average cost in hospital were recorded after treatment. Results The average wound healing time of patients in improved closed negative pressure drainage combined with hyperbaric oxygen group was(6.06 ± 0.23)days, while the granulation tissue growth time was(16.13 ± 2.89)days, both of them were much shorter than the control group[(15.46 ± 4.68)days and(28.60 ± 3.50)days respectively],as well as the closed negative pressure drainage group [(7.43 ± 0.75) days and (22.67 ± 4.34) days respectively], and the differences were statistically significant which the F values equaled to 6.213 and 8.451, P values all less than 0.05. The total healing rate of patients in closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group were both 100.00%(52/52), the difference was statistically significant compared with control group (χ2=6.89, P<0.05). The average hospitalization days of the patients in the closed negative pressure drainage group and improved closed negative pressure drainage combined with hyperbaric oxygen group were (8.20 ± 1.49) days and (7.45 ± 0.42)days, the antibiotic cost were(5 068.34 ± 1 074.68)RMB and (5 001.00 ± 456.00) RMB, the average total cost were (9 457.43 ± 647.23)RMB and (9 249.00 ± 367.00)RMB, all these indexes were much lower that which in control group[(18.40 ± 5.89)days,(21 000.43 ± 2 036.48) RMB and (31 000.66 ± 2 711.36) RMB], and the differences were statistically significant, F values equaled to 15.221, 29.434 and 81.220 each, P values were all less than 0.01. Conclusions Improved closed negative pressure drainage combined with hyperbaric oxygen method could improve the clinical effect of patients with oral and maxillofacial space infection, speed up the granulation tissue, shorten the in-hospital time as well as reduce the medical cost.
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Objective To explore the curative effect of modified closed negative pressure drainage on abnormal abdominal incision. Methods Sity-three patients with abnormal healing of abdominal incision in our hospital from January 2012 to June 2013 were selected as the observation group. Another 50 patients from January to December 2011 were assigned to the control group. The former was treated after debridement with human recombinant surface growth factor and modified closed negative pressure drainage,while the latter after debridement with anti-infection and dressings of ethacridine or gentamicinsolution as well as with infrared therapy. The two groups were compared in terms of the frequency,time and cost of changed dressings,and the healing time of the incisions.Results There was insignificant difference in the cost of changed dressings between the two groups(P>0.05). However,the differences were statistically significant in terms of the frequency and time of changed dressings and the healing time of the incisions(P<0.05). The observation group was significantly superior to the control group.Conclusions Modified closed negative pressure drainage is effective in accelerating the healing in abnormal abdominal incisions,reducing the frequency and the time of changed dressings,and easing the economic burdens of the patients,which is suggested to be popularized and applicable in the pimary hospitals.