Evaluation methods: Visual inspection of fresh wounds and growth of granulation tissue; measurement of wound area before and after treatment; before and after treatment, wounds were taken 0.40.6g tissue for quantitative bacterial culture, calculate the number of bacteria per gram of tissue. Results Eighteen patients had an area of ​​12120cm2 before wound healing, with an average of 44.4cm2. Bacterial cultures were all positive. Among them, 8 were Staphylococcus aureus, 4 were E. coli, 3 were Pseudomonas aeruginosa, and 2 were Pseudomonas aeruginosa. Proteus, 1 case was Bacillus cereus and Proteus, and the number of bacteria exceeded 105g. After vacuum sealing technology treatment 1430d, an average of 18.6d, the wound area was reduced to 9.5100cm2, an average of 37.2cm2; bacterial culture was negative in 13 cases, positive In 5 cases, the number of bacteria was far less than 105g, and no new pathogenic bacteria were found on the wound surface. Fresh wounds were observed with the naked eye. The exposed bone surface was covered with thin layer of granulation tissue. After free skin grafting, the wounds healed. Among them, 14 cases were followed up for 1.536 months, with an average of 8.2 months, and no recurrence of infection. Typical cases. a. Right shin bone osteomyelitis bone dry and necrosis after trauma; b. After debridement vacuum sealing technology treatment; c. Fresh wounds after treatment; d. Wound healing after free skin graft, infection recurrence after 6 months discuss clinical application When composite synthetic dressings (such as PVAPU dressings) cover non-clean wounds, the exudates or necrotic tissue of the wounds can accumulate under the dressings and cannot be drained, which can easily cause or aggravate the infection of the wounds. The author introduces the silicone tube with side holes into the inner layer foam PVA of the composite synthetic dressing. The silicone tube is connected to the negative pressure bottle and it becomes a vacuum sealed wound. The author et al [4] used a drip tube in some cases to clean the wound with liquid containing antibiotics and to prevent drainage tube blockage. However, special care should be taken in clinical operations. The drip rate is slightly faster. The film will break or tear. Fleischmanns et al. [1,2] and Mullner et al. [3] did not use a drip tube and could still effectively prevent and control wound infections because the mechanism of vacuum closure was to create a continuous negative pressure on the wound surface, keeping the PVA foam in close contact. The wound surface eliminates the dead space and stimulates the growth of granulation tissue. At the same time, it actively drains the wound surface through the pores of the PVA foam and the lumen of the silicone tube. Due to the filtering effect of the pores, the silicone tube is not clogged, but the PVA foam surface is full of pores, and it is impossible to be completely blocked by the necrotic tissue or foreign matter, and the pores are meshed together to form a mesh, thereby ensuring the smooth drainage of the wound surface. Therefore, this group of patients also did not use infusion tube, the effect is also excellent. Open fractures and wound infections are often caused by improper early treatment of open fractures. The treatment of such wounds is very difficult. The traditional treatment method is divided debridement, dressing open wounds, wound infection control, fresh granulation tissue after the use of free skin graft or flap to repair the wound. Due to open wound drainage is passive drainage, drainage is not sufficient, there may be a secondary hospital infection, and the moisture evaporation of the wound may lead to tendon or bone dry and necrosis, so that the infection is difficult to control, thus losing the chance of tissue repair, or even had to amputation treatment. A 32-year-old female patient in this group was treated for amputation at 3 months after treatment in his hospital. He was transferred to our hospital and treated. He successfully preserved the limb, healed the wound, and he received a vascularized iliac bone graft 3 months later. Basic walking is now normal. The main reason for the uncontrollable wound infection is poor drainage [3]. The advantage of this method of treatment lies in the thorough debridement and drainage of the wound, which can effectively control the wound infection. In addition, this method temporarily seals the wound similar to natural skin, avoids secondary infections, makes the local environment closer to the physiological state, keeps the wound moist, and prevents dehydration, dryness and necrosis of muscles, tendons, periostes, and bones. In this group of 18 cases of open wound combined wounds, 9 cases of post-traumatic chronic osteomyelitis, preoperative bacterial culture wound number more than 105g, after this technology, the infection is controlled, the wound healing rate of 100% Mullner et al [3] applied this technique to treat 16 open fracture combined wounds, of which 2 failed, all of which were acute infections, with plate plus screws or intramedullary nails. The wounds treated by the author were all subacute or chronic infections, and all were fixed by external fixation devices. This may be the reason for the difference in treatment outcome between the two groups of patients. The PVA foam is kept in a sterile and sealed condition while keeping it wet. After the vacuum closes the wound, the PVA foam gradually dries and the area shrinks as the liquid of the wound gradually decreases, pulling the wound toward the central contraction, and the negative pressure formed on the wound surface. It also helps shrink the wound. Therefore, vacuum sealing technology is beneficial to shrink the wound and save skin. Mul-lner et al. [3] used this technique to treat an ankle compression ulcer and the wound was reduced by 80%. The wound in this group was reduced by 16.2%. In order to minimize the wound, PVA foam can be trimmed to be slightly smaller. The wound, using its elasticity will be more conducive to the reduction of the wound. The author's experience in the early treatment of wounds without this experience may be one of the reasons for the large difference in the area of ​​wounds between the two groups of patients. In short, vacuum sealing technology can effectively control the wound infection, promote the growth of granulation tissue of the wound, and facilitate the shrinkage of the wound surface, saving the supply of skin, it is worth promoting. Nitrogen Generator For Chemical Nitrogen Generator For Chemical,Nitrogen Generator Stable,High Cost Performance Nitrogen Generator,Wonderful Performance Nitrogen Generator Jiangsu Minnuo Group Co.,Ltd , https://www.jsmngroupcn.com
Vacuum sealing effect to release the opening-closing loss and sequential dyeing structure
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