摘要
目的比较头面颈部犬咬伤一期缝合与延期缝合的临床效果。方法收集郑州大学第五附属医院2017年12月至2019年12月496例头面颈部犬咬伤患者的临床资料,按伤口的缝合方法分成一期缝合组(352例)和延期缝合组(144例)。对两组患者的伤口均按犬伤要求处理,一期缝合组修整皮缘并缝合伤口,无菌辅料覆盖包扎;延期缝合组处理完伤口后直接无菌敷料覆盖创面,按时换药,伤口延期缝合。对两组患者术后均常规使用抗生素并按时注射狂犬疫苗和破伤风疫苗。对比分析两组患者的伤口感染情况及伤口最佳愈合情况。结果一期缝合组352例患者中出现不同程度伤口感染共有18例(5.11%),延期缝合组144例患者中出现不同程度伤口感染共有7例(4.86%),两组患者伤口感染率比较,差异无统计学意义(P>0.05)。一期缝合组患者伤口最佳愈合共310例(88.07%),延期缝合组患者伤口最佳愈合共88例(61.11%),一期缝合组比延期缝合组的伤口最佳愈合占比更高(P<0.05)。两组患者伤口最佳愈合评分比较,差异有统计学意义(P<0.05)。两组患者均未出现全身性感染,且随访6个月中均未出现狂犬病及破伤风。结论对比头面颈部犬咬伤伤口的一期缝合与延期缝合,其伤口感染率几乎相同,但对比伤口的最佳愈合情况,一期缝合要比延期缝合的美观效果更好,因此,对于头面颈部犬咬伤伤口,建议伤口充分处理后行一期缝合。
Objective To compare clinical effects of primary suture and delayed suture on dog bite wound of head,face and neck.Methods The clinical data of 496 patients with dog bite wound of head,face and neck in the Fifth Affiliated Hospital of Zhengzhou University from December 2017 to December 2019 were collected.According to the suture method of the wound,the patients were divided into primary suture group(352 cases)and delayed suture group(144 cases).The wounds of the two groups of patients were treated according to the requirements of dog injuries.In the primary suture group,the skin margin was repaired and the wound was sutured,and the sterile excipients were covered and bandaged.In the delayed suture group,the wound was covered with aseptic dressing directly after the wound was treated,the dressing was changed on time,and the wound was delayed sutured.Patients of two groups were routinely treated with antibiotics and injected with rabies vaccine and tetanus vaccine on time.Wound infection and optimal wound healing were compared between the two groups.Results Among the 352 patients in the primary suture group,there were 18 patients with different degrees of wound infection(5.11%).Among the 144 patients in the delayed suture group,there were 7 patients with different degrees of wound infection(4.86%).There was no difference in wound infection rate between the two groups(P>0.05).There were 310 cases(88.07%)with the best wound healing in the primary suture group and 88 cases(61.11%)in the delayed suture group.The proportion of optimal wound healing in primary suture group was higher than that in delayed suture group(P<0.05).There was difference in the score of optimal wound healing between the two groups(P<0.05).There was no systemic infection in the two groups of patients,and there was no rabies or tetanus during the 6-month follow-up.Conclusion Comparing the primary suture and delayed suture on dog bite wound of head,face and neck,the wound infection rate is almost the same.However,compared with the best wound healing
作者
韩云鹏
杨华
伍静
葛文明
HAN Yunpeng;YANG Hua;WU Jing;GE Wenming(Department of Emergency Surgery,the Fifth Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2021年第9期1537-1540,共4页
Henan Medical Research
基金
Ⅲ级暴露犬咬伤伤口进行一期缝合的临床研究河南省医学科技公关联合共建项目(2018020249)。
关键词
犬咬伤
一期缝合
延期缝合
dog bite wound
primary suture
delayed suture
