地震后送骨科伤员开放创面的治疗分析
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摘要
目的探讨地震后送骨科伤员开放创面的治疗策略及治疗效果。方法本组24例地震后送骨科伤员共28处开放创面,分别采用清创、封闭式负压吸引处理伤口,根据不同伤口情况分别采用直接缝合6例9处、游离植皮12例13处、带蒂皮瓣转移加游离植皮4例4处以及游离皮瓣加游离植皮术覆盖创面2例2处。同时选用敏感抗菌素、营养支持等药物治疗。结果 24例地震后送骨科伤员28处开放创面全部愈合。结论地震后送骨科伤员开放创面多合并感染,需积极治疗,采用合理的治疗策略可以加速伤口愈合,尽早恢复肢体功能。
Objective To explore the treatment strategy and therapeutic effects on the treatment of open wounds on transportation orthopedic patients after earthquake.Methods Retrospective study was applied in 24 cases with 28 open wounds on the orthopedic patients after earthquake.The patients were treated with debridement and vacuum-sealing drainage(VSD).Then the open wounds were closed with suturation,skin grafting,pedicle flap and free flap transplantation respectively.The sensitive antibiotics and nutritional support were administrated according to the patient's condition.Result Twenty-four cases with 28 open wounds on the orthopedic patients healed completely on time.Conclusions The open wounds in orthopedic patients after earthquake follow with concurrent infection mostly.With the perfect treatment strategy,the wounds healing and the limb function recovery would be accelerated.
Objective To explore the treatment strategy and therapeutic effects on the treatment of open wounds on transportation orthopedic patients after earthquake.Methods Retrospective study was applied in 24 cases with 28 open wounds on the orthopedic patients after earthquake.The patients were treated with debridement and vacuum-sealing drainage(VSD).Then the open wounds were closed with suturation,skin grafting,pedicle flap and free flap transplantation respectively.The sensitive antibiotics and nutritional support were administrated according to the patient's condition.Result Twenty-four cases with 28 open wounds on the orthopedic patients healed completely on time.Conclusions The open wounds in orthopedic patients after earthquake follow with concurrent infection mostly.With the perfect treatment strategy,the wounds healing and the limb function recovery would be accelerated.
引文
[1]王正国.灾难和事故的创伤救治[M].北京:人民卫生出版社,2005.10-12.
[2]刘飞,罗晴瑜,梁智.封闭式负压引流技术的原理与创面修复[J].中华损伤与修复杂志.2008,3(4):487-492.
[3]李建飞,黄巧玲.VSD治疗骨科创伤及感染创面的临床疗效观察[J].实用临床医学,2009,10(7):51-52.
[4]Stechmiller JK,Kilpadi DV,Childress B,et al.Effect of Vacu-um-Assisted Closure Therapy on the expression of cytokines andproteases in wound fluid of adults with pressure ulcers[J].WoundRepair Regen,2006,14(3):371-374.
[5]Neubauer T,Bayer GS,Wagner M.Open fractures and infection[J].Acta Chir Orthop Traumatol Cech,2006,73(5):301-312.
[6]王颖莹,王辰允,张伟,等.野战环境下医院感染的预防与控制[J].中华医院感染学杂志,2008,18(3):363-365.
[7]石海鸥,王力红,张京利,等.抗菌药物应用合理性干预前后对比分析[J].中华医院感染学杂志,2006,16(4):428-430.
[8]董惠娟,李小军,杜满庆,等.地震灾害心理伤害的相关问题研究[J].自然灾害学报,2007,16(1):153-158.
[2]刘飞,罗晴瑜,梁智.封闭式负压引流技术的原理与创面修复[J].中华损伤与修复杂志.2008,3(4):487-492.
[3]李建飞,黄巧玲.VSD治疗骨科创伤及感染创面的临床疗效观察[J].实用临床医学,2009,10(7):51-52.
[4]Stechmiller JK,Kilpadi DV,Childress B,et al.Effect of Vacu-um-Assisted Closure Therapy on the expression of cytokines andproteases in wound fluid of adults with pressure ulcers[J].WoundRepair Regen,2006,14(3):371-374.
[5]Neubauer T,Bayer GS,Wagner M.Open fractures and infection[J].Acta Chir Orthop Traumatol Cech,2006,73(5):301-312.
[6]王颖莹,王辰允,张伟,等.野战环境下医院感染的预防与控制[J].中华医院感染学杂志,2008,18(3):363-365.
[7]石海鸥,王力红,张京利,等.抗菌药物应用合理性干预前后对比分析[J].中华医院感染学杂志,2006,16(4):428-430.
[8]董惠娟,李小军,杜满庆,等.地震灾害心理伤害的相关问题研究[J].自然灾害学报,2007,16(1):153-158.
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