开放骨折创面不同剂量冲洗液冲洗后局部细菌量与感染发生的关系

Relation of local bacteria quantity and the incidence of infections after rinsing open fracture wound with different doses of rinses

    摘要
  • 摘要: 目的 探讨开放骨折创面采用不同剂量冲洗液冲洗后局部细菌量与感染发生的关系,为开放骨折创面冲洗液剂量的选择提供科学依据。方法 选取2014年5月-2015年5月收治的开放骨折患者87例,给与生理盐水和聚维酮碘以2:1比例混合配置的冲洗液进行冲洗,在冲洗量1、2、4、5L时分别采集局部创面组织进行细菌培养,观察后期创面感染率,采用SPSS18.0软件对数据进行统计分析。结果 87例患者冲洗前及冲洗量1 L、2 L、4 L、5 L时创面细菌培养阳性率分别为87.36%、41.38%、12.64%、4.60%、3.45%,创面细菌培养阳性例数分别为218、88、40、9、8,阳性率及CFU/cm2为冲洗前＞冲洗量1L＞冲洗量2 L＞冲洗量4 L＞冲洗量5 L,比较差异均有统计学意义(P<0.05);Gustily分型Ⅱ型、Ⅲ型患者冲洗前阳性率分别为85.71%、88.89%,冲洗量1 L时阳性率为38.10%、44.44%,冲洗量2L时阳性率为7.14%、22.22%,冲洗量4L时阳性率为2.38%、6.67%,冲洗量5 L量时阳性率为2.38%、4.44%,Ⅱ型、Ⅲ型患者创面细菌阳性率及CFU/cm2数冲洗前＞冲洗量1 L＞冲洗量2 L＞冲洗量＞5 L,比较差异均有统计学意义(P<0.05);患者后期创面感染发生率为3.45%。结论 冲洗液对开放骨折创面冲洗后能有效降低创面细菌量及感染发生率,最佳冲洗量GustilyⅡ型患者在2 L、Ⅲ型患者在4 L左右。

     

    Abstract: OBJECTIVE To explore the relation of local bacteria quantity and the incidence of infections after rinsing open fracture wound with different doses of rinses, and to provide reference for the selection of dose of open fracture wound rinses. METHODS A total of 87 patients with open fractures admitted in our hospital were selected from May 2014 to May 2015. They were given mixed configuration of normal saline and iodine with the proportion of 2-1 ratio to wash the wound. When the washing volumes are 1L, 2L, 4L and 5 L, local wound tissue was collected to carry out bacterial culture, and late infection of the wound tissue was observed. RESULTS The positive rate of bacteria for the culture of the wound tissue of the 87 patients before rinsing and rinsing with the volume of 1L, 2L, 4L and 5 L was respectively: 87.36%, 41.38%, 12.64%, 4.60% and 3.45%, and the wound specimens were respectively cultured positive in 218, 88, 40, 9 and 8 patients. The positive rate and CFU/cm2 were both: before rinsing＞1L rinsing dose＞2 L rinsing dose＞4 L rinsing dose＞5 L rinsing dose. The comparative differences were all significant (P<0.05). The positive rate of Gustily classification in patients with type II and type III before rinsing were 85.71% and 88.89% respectively; for 1L rinsing dose were 38.10% and 44.44%; for 2L rinsing dose were 7.14% and 22.22%; for 4L rinsing dose were 2.38% and 6.67%; for 5L rinsing dose were 2.38% and 4.44%. The positive rate of bacteria for the culture of the wound tissue and CFU/ cm2 in patients with type II and type III were: before rinsing＞1 L rinsing dose＞2 L rinsing dose＞4 L rinsing dose＞5 L rinsing dose, and comparative differences were significant (P<0.05); the infection rate for patients with late wound was 3.45%. CONCLUSION Rinses for open fractures can effectively reduce the bacteria of the wound and the incidence of infections, and the best rinsing dose for Gustily type II patients is 2 L, and 4 L around for type III patients.

     

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