| Background and Objectives:Oral and maxillofacial space infection is one of the common diseases of oral and maxillofacial surgery.Because of the special anatomy structure of oral and maxillofacial part,infection are easily to spread to neighboring tissues space and organs.It can spread into the mediastinum,intracranial,even cause serious complications such as difficulty in breathing,electrolyte disorder,multiple organ failure,which are threatening to life.Traditional treatment is abscess incision and drainage,repeated irrigation and dressing change,until no pus outflow.Incision and drainage wound natural healing or secondary debridement suture.However,the traditional treatment is a kind of passive irrigation drainage,which has many disadvantages.The vacuum sealing drainage technology(VSD)is a new kind of washing drainage device,applied in the maxillofacial space infection,which is expected to improve and solve the disadvantages of traditional therapies.At present,there are few studies on the clinical treatment evaluation of VSD.The purpose of this study is to observe and evaluate the efficacy and value of vacuum sealing drainage technology combined with continuous negative pressure drainage and physiological saline continuous irrigation in the treatment of oral and maxillofacial space infection through the comparison of vacuum sealing drainage technology and conventional open drainage technology,so as to find a more effective treatment for oral and maxillofacial space infection.Materials and Methods:1.Clinical Data:58 patients of routine incision and drainage treatment and 58patients of VSD treatment were randomly selected in all the oral and maxillofacial space infection patients treated in our hospital from March 2012 to February 2018.They were divided as traditional treatment group and VSD group.Selection criteria:1)oral and maxillofacial space infection;2)preoperative specialist examination,local puncture,CT or ultrasound imaging examination to confirm the formation of abscess,and surgical incision and drainage;3)complete case data.2.Method:Patients’case data were recorded:1)general information:age,gender,source of infection,and presence or absence of systemic diseases;2)preoperative and postoperative white blood cell count,degree of mouth opening and degree of pain(wong-baker facial expression scale);3)treatment:treatment method,length of stay,length of postoperative scar,and number of dressing changes.SAS 9.4 software was used for statistical analysis of the data,and the therapeutic effects of the two groups of patients.Wilcoxon rank sum test was used for the comparison of age,WBC count,length of stay,degree of opening mouth,scar length,and number of dressing changes,and chi-square test was used for the comparison of gender,systemic disease,source of infection,and degree of pain.P<0.05 was considered statistically significant.Results:1.Comparison of preoperative clinical data between the traditional treatment group and the VSD groupIn this study,58 cases of the traditional treatment group,including 24 males,34females and 58 cases of VSD group,including 19 males and 39 females,showed no statistical difference in gender comparison between the two groups(P=0.3386).There were 2 cases of mediastinal infection in the traditional treatment group,56 cases of non-mediastinal infection,3 cases of mediastinal infection in the VSD group and 55cases of non-mediastinal infection.There was no statistically significant difference between the two groups(as shown in theχ~2 test,P=0.649).There were 22 cases of other diseases in the traditional treatment group and 36 cases of no other diseases.There were 28 cases of other diseases in the VSD group and 30 cases of no other diseases.In the traditional treatment group,there were 48 cases of dental infection,10cases of non-dental infection,53 cases of dental infection and 5 cases of non-dental infection in the VSD group.There was no statistical difference between the two groups(as shown inχ~2 test,P=0.1683).The average age of the traditional treatment group(42.00±24.41y)was significantly lower than that of the VSD group(53.24±19.97y),and the difference was statistically significant(Wilcoxon rank sum test,P=0.0178).Traditional treatment group,on average,the WBC value(14.82±4.22×10~9/L)below the VSD group(17.06±6.02×10~9/L),the difference was statistically significant(Wilcoxon rank and inspection,P=0.0164).The pain degree of the traditional treatment group(14 cases of mild pain,17 cases of moderate pain,27cases of severe pain)was significantly lower than that of the VSD group(5 cases of mild pain,15 cases of moderate pain,38 cases of severe pain),and the difference was statistically significant(χ~2 test,P=0.0451).There were 6 cases of secondary operations in the traditional treatment group,52 cases of non-secondary operations,18 cases of secondary operations in the VSD group and 40 cases of non-secondary operations,and the difference was statistically significant(P=0.0062).2.Comparison of postoperative clinical efficacy between traditional treatment group and VSD groupThe average hospitalization time(11.89±2.45d)of the VSD group was significantly shorter than that of the conventional treatment group(16.91±6.97d),and the difference was statistically significant(Wilcoxon rank sum test,P<0.0001).In 3 d the VSD group the WBC value(8.99±2.39×10~9/L)significantly lower than the conventional treatment group(11.88±3.52×10~9/L),and the difference was statistically significant(Wilcoxon rank and inspection,P<0.0001).In the VSD group,the open mouth limited remission value(1.30±0.54cm)was significantly higher than that in the conventional treatment group(0.88±0.30cm),and the difference was statistically significant(Wilcoxon rank sum test,P<0.0001).The scar length(2.78±0.72cm)of the VSD group was observably smaller than that of the conventional treatment group(3.68±1.68cm),and the difference was statistically significant(Wilcoxon rank sum test,P=0.0004).The number of drug exchanges in the VSD group(2.62±0.70 times)was significantly lower than that in the traditional treatment group(23.72±7.71 times),and the difference was statistically significant(Wilcoxon rank sum test,P<0.0001).In the VSD group,the pain degree on the 7th day after surgery(46 cases of mild pain,11cases of moderate pain,1 case of severe pain)was significantly lower than that of the traditional treatment group(31 cases of mild pain,12 cases of moderate pain,and 15cases of severe pain),and the difference was statistically significant(P=0.0005).Conclusion:1.Compared with conventional incision and drainage treatment,vacuum sealing drainage technology can shorten the hospitalization time of patients,reduce postoperative scar length,improve facial aesthetics,rapidly relieve pain and limit degree of mouth opening,and significantly improve the living quality of patients.2.Vacuum sealing drainage technology can reduce the workload of medical staff and effectively save medical resources.In conclusion,vacuum sealing drainage is a more effective method to treat oral and maxillofacial space infection,which is worthy of clinical application. |
PDF Full Text Request