| Objective:This topic were randomized controlled studies and follow-up through clinical cases of intractable wounds,by comparing treatment the curative effect of the VSD combined with the silver ion dressings and the conventional treatment in the refractory,aims to explore the VSD combined with silver ions dressings from the dressing method of treatment effect on refractory wound.Methods:Choose 50 patients with refractory wounds according to exclusion and inclusion criteria during the period of January 2014-December 2015 from the hospital and then divided into two groups randomly,the treatment group used the VSD technique combined with silver ions wound dressings,control group used the traditional treatment methods,two groups of patients were given in foundation treatment in the course of treatment and accept clinical observation for 60days.Treatment group and control group all need to continuously observe and record the indicators of patients,including:Single changing dressing time,twice changing dressing interval,.Patients’level of pain,in the process of applying the secondary trauma score.Total costs.Before treatment and treatment of 7 days,14 days or 21 days of secretions culture results.In 20th day,40th day or 60th day,evaluated the curative effect and prognosis of outcome.Used statistical methods to analyze the data collected,the relevant results were obtained.If the patients’wounds healed during the observation period,they would be automatically ended treatment,observational period still unhealed patients were given in further treatment according to the requirements of the patient and family’s intentions.Results:After the clinical observation period of 60 days,with the result of data analysis the following conclusions:1.The average interval between twice changes has significant difference(t=11.822,P<0.050);For the average time needed for a single treatment(t=1.026,P>0.050)has no significant difference;Overall treatment costs(t=0.699,P>0.05)difference was not significant,but according to the results of 5807.72±2397.95 and 6236.20±1912.37 cost can be seen that the treatment group was lower than those of control group;2.Secondary trauma score(t=18.151,P<0.050),the VAS score whilechanging dressings(t=4.287,P<0.05)and intervals between twice changes(t=3.657,P<0.050)was statistically significant difference;3.The treatment group cure rate was 60%,while the control group was only20%;Recovery rate(?~2=8.333,P<0.050)has significant difference;4.Calculated respectively in the treatment of 20 days,40 days and 60 days of ulcer area reduction ratio,20 days(t=4.083,P<0.050),40 days(t=4.123,P<4.123)and 60days(t=3.341,P<0.050)all has significant difference.5.Two groups of patients’bacterial culture in the treatment of 21 days later again were completely overcast.the 7th day’s overcast rate(?~2=4.763,P<0.050)and the 14th day’s overcast rate(?~2=10.357,P<0.050)all has significant difference.Conclusion:VSD technology combined with silver ions dressing was widelyapplication in the treatment of refractory,this technique can minimize wound damage degree as far as possible,promote the growth of granulation tissue,and make the wound condition tend to be simple,can improve wound healing,advance the operation time and improve the success rate of surgery.This technology in reducing the medical work,prevention and treatment of wound infection,shorten the length of hospital stay,reduce hospitalization expenses,reducing patient pain were better than that in control group,and for more complex wound also achieved good therapeutic effect.The simple negative pressure suction device used in this department is easy to get,easy to operate,and can further reduce the cost of treatment,and the therapeutic efficacy is comparable with that of professional equipment. |
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