The Application Of Two Kinds Of Modified Negative Pressure Washing Device On Stage ? Stage/? Pressure Ulcers

ObjectivesTo explore the therapeutic effects of three-cavity catheter negative pressure washing device and stomach tube negative pressure washing device on stage ? stage /? pressure ulcers,observe the wound area reduction rate,stealth depth,time of granulation tissue cover 76%-100%,Bates-Jensen score,Bacteria Counting.Compare and analyze the effect and cost effectiveness of the two treatments on stage ? stage /? pressure ulcers.Try to provide safe and effective,economical and practical,easy operation clinical treatment method for the stage ?/? pressure ulcers.MethodsThis study was a clinical quasi-experimental trial,chosen stage ? stage /? pressure ulcer patients who were hospitalized in Seventh people's hospital of Shenzhen during 2014 November to 2016 March as screening population.All the screening population accepted based therapy for one week,including health education,nutrition management,local debridement and infection control etc.A week later,according to the inclusion and exclusion criteria to determine the research objects of study.Then the research objects were according to the sequence of admission number using a simple digital table method randomly divided into experimental and control group.Experiment group used three-cavity catheter negative pressure washing device;Control group used stomach tube negative pressure washing device,two groups were refered to negative pressure wound therapy(NPWT)operation procedures for wound treatment.The intervention was as long as 21 days.Information of all patients was recorded.Recorded and analyzed two groups 7th day,14 th day and 21 th day of wound area reduction rate,stealth depth;4th day,7th day,14 th day and 21 th day of Bates-Jensen score,Bacteria counting;time of granulation tissue cover 76%-100%,the number of times of dressing change,the cost of dressing change,the times of dressing and the number of pipe blocking.Theinformation were collected and statistical analyzed.Count data is described by the frequency(percentage)[n(%)],between the groups compared using chi square test;measurement data if consistent with positive state distribution by the description,does not comply with the median and inter quartile range [M(P25,P75)] description;data using independent samples t test,rank sum test or repeated measures variance analysis.Results1.General Information:The study included 59 cases,55 effective cases,four patients withdrew midway for various reasons,therefore 27 in experiment group and28 in control group in the statistical analysis finally.There were no significant difference between the two groups of demographic data,pressure ulcer related information and metabolic index(P>0.05).2.Wound Index2.1 Wound area reduction rate.The experimental group and the control group14 th day and 21 th day area reduction ratio comparison difference has statistical significance(F=-2.956,-9.128,P < 0.05),7th day difference has no statistical significance(F=-1.223,P>0.05);7th day,14 th day and 21 th day depth reduction ratio difference has no statistical significance(F=0.180,0.029,-0.086,P > 0.05).Further repeated measures analysis of variance showed that area reduction ratio of two groups in using different interventions,time,between intervention and time were statistically significant difference(F=57.922,1198.943,57.399,P < 0.05);Depth reduction ratio of two groups in different time was statistically significant difference(F=1.708,P < 0.05),different interventions,intervention and time interaction difference has no statistical significance(F=0.000,0.011,P>0.05).2.2 Stealth depth.The experimental group and the control group 7th day,14 th day and 21 th day stealth depth difference has no statistical significance(F=-0.814,-0.502,-0.490,P > 0.05).Further repeated measures analysis of variance showed that in different time was statistically significant difference(F=55.913,P<0.05),different interventions,intervention and time interaction difference has no statistical significance(F=0.534,0.200,P>0.05).2.3 Time of granulation tissue cover 76%-100%.Experimental group(15.00±2.04)days,control group(19.04±2.73)days,the difference was statistically significant by t test(t=6.197,P<0.05).2.4 Bates-Jensen score.The experimental group and the control group 7th day,14 th day and 21 th day difference has statistical significance(F=2.172,3.700,4.924,P<0.05),4th day difference has no statistical significance(F=0.464,P>0.05).Further repeated measures analysis of variance showed that in using different interventions,time,between intervention and time were statistically significant difference(F=4.832,369.281,8.041,P<0.05).3.Laboratory indexThe experimental group and the control group 4th day,7th day,14 th day and 21 th day bacteria counting difference has statistical significance(F=6.506,Z=-5.566,-5.944,-4.783,P<0.05).Further repeated measures analysis of variance showed that using different interventions,time,between intervention and time were statistically significant difference(F=4.586,5351.018,6.014,P<0.05).4.Cost effectiveness.The experimental group and the control group the number of times of dressing change,the cost of dressing change,the times of dressing and the number of pipe blocking difference has statistical significance(F=5.698,2.300,3.039,Z=-2.413,P<0.05).Conclusions1.Two kinds of modified negative pressure washing device treated the stage ? stage /? pressure ulcers has good curative effect.Compared with the efficacy of the two groups,three cavity guide catheter pressure flushing device in reducing the wound area and stealth depth,promoting the growth of granulation tissue,reducing the score of Bates-Jensen,reducing wound bacteria count and cost effective better than tube negative pressure flushing device,but depth changes are similar.2.During the study period,the experimental group and the control group patients had no adverse reactions,two kinds of device has good safety.3.This study confirmed the three cavity catheter pressure flushing device in the treatment of stage ? stage /? pressure ulcers is safe and effective,economical andpractical,easy to operate,for clinical treatment the bedsore provides a kind of new method,has good application prospects.