Observation On The Clinical Efficacy Of Negative Pressure Drainage In The Treatment Of Chronic Refractory Wounds

1.1 The main purposes,methods and results of this studyObjective In this study,negative pressure drainage was used to treat chronic refractory wounds(diabetic foot,lower extremity venous ulcer and deep ii° burns of the elderly)and the effects of negative pressure suction on total cure time of chronic wound,survival of skin graft and recurrence after operation were discussed through clinical retrospective analysis.To provide an alternative and effective treatment regimen for clinical treatment.Methods Retrospective analysis of 100 cases of type 2 diabetes treated in February 2013 ~2016 February and the patients with chronic ulcer of shank or foot were divided into two groups,and the clinical efficacy of two groups were compared.In the observation group,50 cases,the average age(55.21±2.26)years old,including 35 male patients,15 female patients,of whom 10 patients were calf ulcers,40 cases of foot ulcers.In the experimental group,the wound was closed with negative pressure drainage,local braking,irrigation and drainage tube and sealing material on demand.In the control group,50 cases,the average age(55.52±2.25)years old,including 39 male patients,11 female patients,including 12 patients with calf ulcer,38 cases of foot ulcer,the wound regularly traditional dressing and other treatment.To compare the complications,the infection and the duration of the two-stage operation in the two groups of wound treatment.The clinical data of 19 patients with venous ulcer of the lower limb(11 cases in the foot boot area,5 in the anterior tibial,2 in the foot back and multiple ulcers in 1 cases)were retrospectively analyzed from October 2015 ~2017 years June.The patients who entered the case were infected by changing dressing,and the parallel free autologous skin graft was transplanted,according to the different treatment in two groups,the experimental group(10 cases)were covered with vac negative pressure sponge material after skin grafting,the control group(9 cases)used traditional dressing treatment,the experimental group external 10~15KPA central negative pressure,Intermittent circulation low pressure suction(negative pressure treatment of 8min,intermittent 2min),after treatment to observe the survival of the skin and survival time,wound healing time,wound infection control.50 elderly patients with deep partial thickness burn of lower extremity in January 2016 ~2017 years were selected as subjects,divided into two groups,and treated with traditional wound dressing in the control group,the negative pressure closed drainage was given to the observation group,and the clinical efficacy of the two groups was compared.Age 65~80?,average age(72.3±5.2)age,divided into two groups,the observation group 25 cases,including 13 male patients,12 female patients,of whom 20 patients were hot-liquid burns,3 cases were flame burns,and 2 cases were scalded with hot objects.In the control group,25 cases,including 14 male patients,11 female patients,including 19 cases of hot liquid burns,4 cases of flame burns,2 cases of hot object scald.Comparing the basic data of the two groups,the p>0.05 and the difference were not obvious.Compare the infection and the duration of the two-stage operation in the two groups of wound treatment.Results All patients had no obvious complications associated with repair of wound treatment in the treatment process,the observation group patients admitted to the wound to reach the feasible two-period operation time(25.68±10.02)days,shorter than the control group(45.58±12.28)days,p<0.05,the survival of skin flap and skin graft in the observation group was significantly superior to that of the control group,p<0.05.Compared with the control group,the survival rate of 66.6%,p<0.05 in the experimental group was as high as 90%,the control group only,Hospitalization time Experimental Group(22.6±7.5)d,compared with the control group(33.4±12.8)d short,p<0.05,the experimental group of wound infection rate was 10%,the control group was as high as 33%.The experimental group was significantly better than the control group after operation.All patients had no obvious complications associated with repair of wound treatment in the treatment process,the observation group patients admitted to the wound to reach the feasible two-period operation time(24.47±9.43)days,shorter than the control group(35.54±13.22)days,p<0.05 in the observation group,the survival of postoperative skin graft was significantly better than that of the control group,p<0.05.1.2 ConclusionCompared with common wound,chronic wound's blood supply and nutrition condition is poor,the use of traditional dressing is relatively longer,and in the process of dressing,the local wound may be infected,rash and other treatment-related complications of delayed healing,while the chronic wound patients with poor physical condition,in the long period of change in the process of the whole body inflammatory reaction syndrome(Systemic inflammatory Response syndrome,sirs)also increases the risk of death.The suction of negative pressure can promote the wound blood supply to a certain extent,to improve the environment of ischemic hypoxia and nutritional disturbance of diabetic foot and lower limb venous ulcer in chronic wound,it provides a good environment for two stage skin graft or flap grafting,and the application of negative pressure closed drainage can increase the fixation of skin graft.Provide better surgical results.Negative pressure closed drainage in the treatment of chronic wounds can effectively shorten the wound healing time,and simple,safe and effective,and even to a certain extent to reduce economic burden,is worthy of clinical application of the treatment.