Vacuum Sealing Drainage (VSD) And Comparative Study Of Traditional Dressing Change In The Treatment Of Pressure Ulcers

Background and purposeThe arrival of information age accelerated rhythm and pace of people’s life,science and technology progress and update the development in the rapid expansionin the field of medicine.Pressure sores, as a kind of intractable disease always hauntus, traffic accidents, natural disasters and all kinds of chronic diseases wantonlybreeding made to increase the incidence of pressure ulcers, though nursing progressand updates, but there are different levels of pressure ulcers, due to treatment is lessthan or inappropriate greatly increase medical resources waste, to patients andfamilies bring heavy burden of economy and society, well serious injury, disability,life threatening. The treatment of pressure sores are diverse, traditional treatmenttherapy, Chinese medicine plaster stick take therapy, the treatment of stem cells andcytokines are many methods, such as in the modern clinical activities. In the processof wound healing, necrotic tissue and cell long in tissues, poor blood supply, causedby hypoxia vascular embolization and necrotic tissue corruption further acceleratedthe occurrence of pressure ulcers. Paraplegic patients caused by passive position andthe bed board thru sites pressure sores, the main location for the sacrum, ischialtuberosity, twilight, in areas such as the big rotor heel bone, before the occipital, iliacspine and internal external ankle and pressure sores in areas such as the good parts. At present, the traditional dressing therapy in the treatment of pressure ulcers hasbeen lagging behind, a new generation of closed negative pressure therapy mainlyUSES the research and development of new biological materials, attached with awound, using the principle of negative pressure to suction the necrotic tissue and cells,then played fast healing purposes. This method due to less pain, lower infection rateamong many reasons favoured in patients and families, but also make the medicalstaff in the treatment of wounds on time, for the medical enterprise’s rapiddevelopment has laid a solid foundation. So no matter from what point of view, allhope that the technology innovation to further development, and compare thetraditional dressing therapy, this technology will have wound healing more perfect asfar as possible, added a guarantee to improve the doctor-patient relationship. In theclosed negative pressure drainage technology in China (vacuum sealing drainage, theVSD) has nearly20years, the application of the technology application in the field ofChinese medicine has been quite mature and widely used in clinical. In the1990s,the university of ULM in Germany trauma surgeon Dr Fleischmann pioneering closednegative pressure drainage technology, the principle of which is mainly through to thewounds sustained pressure suction to improve local blood circulation and removal ofnecrotic tissue and drainage, accelerates the growth and proliferation of granulationtissue, reduce wound bacterial infection, further reduce wound tissue edema, theinitial purpose is used for soft tissue defect and infective wound healing, a largenumber of clinical practice has proved that’s rather an effective wound healing. Sinceour country QiuHuaDe professor will take the lead in the introduction of domesticand promote the new technology, and boldly applied to clinical, in all kinds ofrefractory wounds and skin graft, and other fields have achieved good results. Inrecent years, the technology has matured in our country, mainly used in orthopedics,general surgery and plastic surgery surgical department, to deal with many refractorywound provides powerful help. Object of this research is in July2012to August2012in my department of patients with pressure ulcers, adopt the closed negative pressuredrainage technology and traditional treatment for treatment, and in the hospitalcarried out within the next six months follow-up. For further understanding themechanism of action of the VSD technique in the treatment of pressure ulcers, indications, contraindications, complications, and matters needing attention and so onrelated content, now the clinical observation and comparative study on the relateddata, test the negative pressure drainage treatment of pressure ulcers advantages andexisting problems, and further discuss and improve clinical skills, enhance thepractical effect, expand the scope of application, improve the safety and reliability,reduce the disability rate and mortality of patients with pressure ulcers, improvepatient quality of life, provided strong evidence for the existing medical conditions.MethodsCollect our department since2010from July to July2013, a total of34cases ofclosed negative pressure drainage (VSD) treatment of patients with pressure ulcers,and collected34cases treated with conventional treatment in patients with pressureulcers, sacral pressure sores parts are the tail, respectively defined as the VSDtreatment group and conventional treatment group, follow-up time for six monthsafter discharge. According to clinical observation, record during treatment of pressureulcers wound area, skin graft, curative effect and complications, patients feel pain,hospitalization time and hospitalization expenses, and contrast research of the relateddata and statistical analysis, the conclusions are obtained.Results:1、The VSD treatment group, on average, do the closed negative pressuredrainage after2to4times, granulation tissue wound conditions to graft, secondarysuture or skin graft transplantation patients with30patients (88.2%),4cases needcover flap transposition, average hospitalization days was32.85days. Traditionaltreatment group the bandage on average15.2times, need to secondary suture or skingraft transplantation patients with25cases (73.5%), there are9cases need cover flaptransposition, the average hospitalization day44.27, both difference is significantly (P<0.05).2、The closed negative pressure drainage treatment compared with the traditionaltreatment therapy, patients during treatment significantly reduce pain degree, through McGill pain score, the score is3.01,1.63and1.63and6.02respectively, the twosignificant difference (t=5.163, P <0.01).3、The VSD treatment group (34patients with pressure ulcers during treatmentare adhere to the application of VSD treatment, including3cases with bone exposedand degeneration necrosis. Traditional treatment group has6cases with bone exposedand degeneration necrosis.4、The VSD treatment group compared with the traditional treatment group, theVSD treatment and traditional dressing total costs were6503.3and6503.3yuan and1878.5and508.3yuan, the significant difference (t=8.593, P <0.01), while in thehospital total cost were25946.3and25946.3yuan and9425.1and8549.1yuan, thesignificant difference (t=1.254, P <0.01).Conclusion:Closed negative pressure drainage (VSD) with pressure ulcers woundapplication more widely, the technology can minimize wound damage degree as faras possible, make the injury towards simplification, created a good timing to winearly wound healing. This technology is widely used in the prevention of woundinfection, shorten hospitalization time, relieve pain and reduce the complications ofpatients is superior to the traditional surgical treatment method, and good at dealingwith complex wound is healing. Cleaning in necrotic tissue and bone exposed alsosignificantly superior to the traditional treatment method.