| Background: It is a long-term wasting disease with a high rate of disability and death,which cannot be solved by ordinary dressing changes and has a great impact on the patient’s quality of life.With the improvement of material living standards,patients’ demand for quality of life has also increased.How to accelerate the healing of wounds and improve patients’ quality of life is currently a clinical challenge.In this study,the combination of topical oxygen therapy(TOT)with recombinant bovine basic fibroblast growth factor(rb-b FGF)and vacuum sealing drainage(VSD)was observed.Its feasibility and practicality were analyzed to provide reference for clinical treatment.Methods: Forty patients with chronic refractory wounds admitted to the Department of Plastic and Burns of the First Affiliated Hospital of Bengbu Medical College from October 2020 to August 2022 were selected and randomly divided into a control group and an observation group.The control group was treated with VSD combined with saline irrigation after wound cleaning and dilation,while the observation group was treated with VSD combined with topical oxygen therapy and rb-b FGF solution irrigation.The length of hospital stay and cost,clinical efficacy and NRS pain score were compared between the two groups.H&E staining was performed on the trauma tissue before and 7 days after surgery to observe the histopathological changes,and immunohistochemical staining was performed on the trauma tissue before,7 days and14 days after surgery to detect the expression of VEGF.Results: Compared with the control group,the mean length of stay in the observation group was significantly shorter(34.75 ± 12.01d;27.50 ± 8.91d;t/Z =-2.618;P=0.037)and the mean hospitalization cost was significantly lower(33218.28 ± 15904.49;24283.97 ± 7455.95;t/Z=-2.299;P=0.021),the difference was statistically significant(P< 0.05);in the control group there were 5 cases with significant effect,8 cases with effective effect and 7 cases with ineffective effect,total effective rate 65%,in the observation group there were 6 cases with significant effect,13 cases with effective effect and 1 case with ineffective effect,total effective rate 95%,P=0.048,the total effective rate of treatment in the observation group was higher,the difference was statistically significant(P < 0.05),the NRS scores measured at different times were Statistical difference,F=96.665,P=0.000<0.05,and there was an interaction between time and group;F=16.034,P=0.000<0.05,ANOVA results showed a statistical difference between groups;F=5.205,P=0.028<0.05,i.e.treatment factors in both groups had a significant effect on NRS scores.The NRS scores of both groups were significantly lower than the preoperative scores at 7 and 14 days postoperatively(P<0.05),and the NRS scores of the observation group were significantly lower at 14 days postoperatively than at 7 days postoperatively(P<0.05);there was also a significant difference between the two groups at 7 and 14 days postoperatively(P<0.05).VEGF immunohistochemical staining showed varying degrees of yellowish-brown color,and the expression of VEGF was significantly higher in the observation group than in the control group on postoperative days 7 and 14,and the positive expression of VEGF was significantly higher in both groups on postoperative days 7 and 14.Conclusions:(1)Topical oxygen therapy combined with rb-b FGF combined with VSD treatment has significantly better therapeutic effect than VSD combined with saline rinse treatment;(2)Topical oxygen therapy combined with rb-b FGF combined with VSD treatment can significantly improve the condition of the wound,increase the expression of VEGF,improve the microcirculation of the wound,accelerate the healing of the wound,reduce the pain of the patient,shorten the hospitalization time of the patient and reduce the economic burden of the patient. |
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