负压封闭引流治疗严重感染创面的护理

摘要

[目的]探讨严重感染创面行负压封闭引流(VSD)的护理方法。[方法]对35例严重感染创面先后采用VSD进行治疗。[结果]骨折内固定术后的感染切口及皮肤撕脱伤感染创面更换敷料1次或2次，骨髓炎病人更换2次或3次，骶尾部压疮更换3次或4次，髋关节术后感染更换4次。待创面细菌培养为阴性，肉芽组织生长良好后，皮肤缺损者行植皮，余则行切口缝合，所有创面彻底愈合。[结论]严重感染创面因细菌谱复杂、创面渗液、渗血或脓性分泌物多可能会影响 VSD的疗效。护理过程中首要问题是加强负压管路的管理，维持良好的引流。密切观察并保护创面、评估感染的控制效果对完善治疗方案非常重要。加强营养支持，促进功能锻炼是提高抵抗能力防止并发症的重要环节。%Obj ective:To probe into nursing methods for patients with se-vere infection of wound surface treated with vacuum sealing drainage (VSD).Methods:VSD technique was applied successively in 3 5 cases of patients with severe infection of wound surface.Results:The number of times of dressing change was 1~2 times for patients with infected incisions after internal fixation and infected wound surface after avulsion inj ury of skin,2~3 times for osteomyelitis patients,3~4 times for sacral pressure ulcer patients,4 times for patients with hip postoperative infection.After negative bacterial culture and wound granulation tissue growing well were founded,the skin defect patients underwent skin graft,other patients re-ceived incision suture,all wounds healed completely.Conclusion:The seri-ous infections wounds due to complex bacterial spectrum,wound exudate, bleeding or more purulent secretions may affect the curative effect of the VSD.Primary issue in nursing process is to strengthen the management of negative pressure piping and maintain good drainage.Closely to observe and protect the wound,and assess the effect of infection control is very im-portant for improving treatment options.To strengthen the nutritional support and promote functional exercise is an important part for improving resistance and prevent complications.