| Objective:To observe and evaluate the effect of vacuum sealing drainage for the treatment of chronic ulcer wounds of the limbs, observation and preliminary evaluation of its clinical efficacy to promote its clinical guidance value.Methods:72patients Collected in2011July-2012Nov.72patients of chronic infectious limbs wound cases treated with vacuum sealing drainage were randomly divided into a treatment group and the control group (36cases), including42males and30females,age17-66years, mean43.8years old.15cases of upper and lower limbs of57cases,31cases left and right side of the41cases.37cases of chronic skin ulcers, The fracture postoperative infection in25cases, combined muscle tendon injury in31cases,16cases of diabetes, combined atherosclerosis9cases. Randomized controlled randomization under a hospital order, the Tuolixiaodusan36cases combined with vacuum assisted drainage therapy for the treatment group, to suction drainage treatment for the control group, the conventional radical debridement after admission, based on bacterial culture and susceptibility results of the application of sensitive antibiotic treatment group serving Tuolixiaodusan treatment on the basis of the control group plus scattered seven days for treatment and observation for seven days,14days,21days of wound granulation tissue, blood supply and infection control the situation, according to the the European tissue repair and wound healing the General Assembly chronic wound healing stage, the growth of granulation tissue into the red phase, the granulation tissue fresh, rosy, the wounds filled more than50%, to dismantle the negative pressure drainage device, parallel two skin graft surgery, skin graft surgery, the two groups of patients herein are limb plaster fixed are braking, Taigaohuanzhi, Zhu Huanzhe to maintain correct posture to avoid skin graft shift. Both groups after routine applications improve circulation, anticoagulation therapy, seven days after removal dressings, skin graft survival was observed overall efficacy evaluation in accordance with the purposes of the State Administration of Traditional Chinese Medicine disease diagnosis and efficacy standards "line, the resulting data to do statistical analysis; All cases were followed up.Results:Observe the wound statistical analysis of the results:①treatment group and the control group of patients infected laboratory parameters (WBC, CRP, ESR and bacterial culture) detection analysis, the two groups, the treatment group control infection batter than the control group (P<0.05);②The two groups of patients with bacterial negativity compare bacterial culture negative number of the treatment group was higher than that in the control group (P<0.05).③hemorheology between the two groups of patients group statistical analysis, high shear blood, whole blood, cut, admission plasma viscosity,7d was no statistically significant (P>0.05),14d,21d statistically significant (P<0.05), the treatment group than the control group, whole blood, red blood cell aggregation index improved, but not statistically significant (P>0.05); statistical analysis in the treatment group, and whole blood level statistics significant (P>0.05), high shear whole blood, whole blood, cut, the erythrocytes aggregation index and plasma viscosity admission,7d was no statistically significant (P>0.05),14d significant improvement in the level of the21d still statistically significance (P<0.05), blood viscosity significantly improve the statistical analysis; within the control group, group, erythrocyte aggregation index admission,7d and14d was not statistically significant (P>0.05), compare21d decreased level of red blood cell aggregation whole blood showed no statistically significant (P>0.05), high shear whole blood the admission cut in whole blood and plasma viscosity,7d compare not statistically significant (P>0.05),14d,21d was statistically significant (P<0.05);④skin grafting wound prepare the required time analysis of the statistical test that the time required for the treatment group than in the control group;⑤two sets of skin graft survival contrast to the situation that the survival of skin graft treatment group than the control group.⑥patients comparing total hospitalization time, the difference was statistically significant (P<0.05), the treatment group, shorter hospital stay in the control group.All cases were the follow-up, follow-up time of6-12months (an average of more than8months), none of the two groups patients with wound infection relapse, necrotic skin graft repaired by strengthening cleaning or skin graft. All appearance of the repaired wound look good, both to restore some or all of the skin sensory function.Conclusion:①Tuolixiaodusan combined with vacuum assisted drainage has to promote the growth of granulation, establish a good blood supply, reduce blood viscosity, improve blood circulation, accelerate venous return, reduce and inhibit the inflammation, the fresh growth of granulation tissue with good blood supplythe basement bed to reduce late graft infection and necrosis, shorten the time of the post-surgical treatment, which greatly improve the survival rate of the graft and thereby improve the clinical efficacy;②Tuolixiaodusan combined with vacuum sealing drainage for the treatment of chronic infectious limbs wound overall efficacy satisfaction. |
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