烫伤湿润膏在糖尿病足创面中的应用
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摘要
目的探讨烫伤湿润膏在糖尿病足伤口愈合中的应用。方法选择2016年4月-2017年9月,确诊为Wagner2-4级糖尿病足的患者30例,先行外科扩创手术后使用烫伤湿润膏创面换药,配合精心护理。观察创面愈合时间及愈合情况。结果 8例创面在15天内经换药后完全愈合,瘢痕不明显,11例创面在15-30天内完全愈合,瘢痕不明显,6例创面在30-45天内完全愈合,瘢痕轻度,2例创面完全愈合在45-60天,3例患者依从性差,血糖增高合并摩氏摩杆菌感染和肾病合并科泽柠檬酸杆菌创面愈合超过60天,其中2例最终手术截肢。创面在45天内愈合率在83.33%。创面经换药处理后,创面处无菌状态,有利于创面愈合,在45天内换药有效率在86.67%。结论糖尿病足患者在全身综合治疗控制的基础上,通过烫伤湿润膏给予伤口的处理,加上精心护理,加速创面的愈合,减少患者痛苦,从而减少患者截肢率,提高患者生活质量。
Objective To investigate the application of scald moisturizer in wound healing of diabetic foot.Methods Thirty patients with Wagner grade 2-4 diabetic foot were selected from April 2016 to September 2017. They were treated with scald moisturizing ointment after surgical expansion operation and carefully nursed. The wound healing time and condition were observed. Results 8 cases of wounds healed completely within 15 days after dressing change. The scars were not obvious. 11 cases healed completely within 15-30 days. The scars were not obvious. 6 cases healed completely within 30-45 days. The scars were mild. 2 cases healed completely within 45-60 days. 3 cases had poor compliance. The wounds healed more than 60 days with high blood sugar, Moroccus infection and nephropathy combined with Citrobacter kozae. Two of them were finally amputated. The wound healing rate was 83.33% within 45 days. After dressing change, the wound was sterile, which was conducive to wound healing. The effective rate of dressing change was 86.67% within 45 days. Conclusion On the basis of comprehensive treatment and control, diabetic foot patients can accelerate wound healing and reduce patients' pain by treating wounds with scald moist ointment and careful nursing, thus reducing amputation rate and improving patients' quality of life.
Objective To investigate the application of scald moisturizer in wound healing of diabetic foot.Methods Thirty patients with Wagner grade 2-4 diabetic foot were selected from April 2016 to September 2017. They were treated with scald moisturizing ointment after surgical expansion operation and carefully nursed. The wound healing time and condition were observed. Results 8 cases of wounds healed completely within 15 days after dressing change. The scars were not obvious. 11 cases healed completely within 15-30 days. The scars were not obvious. 6 cases healed completely within 30-45 days. The scars were mild. 2 cases healed completely within 45-60 days. 3 cases had poor compliance. The wounds healed more than 60 days with high blood sugar, Moroccus infection and nephropathy combined with Citrobacter kozae. Two of them were finally amputated. The wound healing rate was 83.33% within 45 days. After dressing change, the wound was sterile, which was conducive to wound healing. The effective rate of dressing change was 86.67% within 45 days. Conclusion On the basis of comprehensive treatment and control, diabetic foot patients can accelerate wound healing and reduce patients' pain by treating wounds with scald moist ointment and careful nursing, thus reducing amputation rate and improving patients' quality of life.
引文
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[4]周红菊,邓瑞文,饶忠,等.藻酸盐敷料治疗糖尿病足溃疡的临床观察和护理[J].护士进修杂志,2012,27(13):1219-1221
[5]Waldecker U.Pedographic classification and ulcer detection in the diabetic foot[J].Foot Ankle Surg,2012,18(1):42-49.
[6]Patel M,McCormick K.Managing Diabetes in People with Foot Complications[M].Management of Diabetic Foot Complications:Spr inger,2015:39-49.
[7]Reekers J A,Lammer J.Diabetic Foot and PAD:The endovascular approach[J].Diabetes Metab Res Rev,2017,28(1):36-39.
[8]Lee KM,Kim WH,Lee JH,et al.Risk foctors of treatment failure in diabetic foot ulcer patients[J].Arch Plast Surg,2013,40(2):123-128.
[9]Richmond NA,Vivas AC,Kirsner RS.Topical and biologic therapies for diabetic foot ulcers[J].Med Clin North Am,2013,97(5):883-898.
[10]万凌.藻酸盐敷料对糖尿病足部窦道伤口治疗的疗效观察[J].吉林医学,2012,33(34):7498-7500.
[11]陈蔚.银离子敷料在糖尿病足感染伤口中的应用[J].中华现代护理杂志,2008,14(10):1178-1179.
[12]徐荣祥.MEBO-DFU再生疗法治疗糖尿病足的规范化流程[J].中国烧伤创疡杂志,2015,27(1):1-16.
[2]国际血管联盟中国分会糖尿病足专业委员会.糖尿病足诊治指南[J].介入放射学杂志。2013,22(9):705-708.
[3]王君俏.循证护理的理论与实践[J].护士进修杂志,2011,26(19):1731-1733.
[4]周红菊,邓瑞文,饶忠,等.藻酸盐敷料治疗糖尿病足溃疡的临床观察和护理[J].护士进修杂志,2012,27(13):1219-1221
[5]Waldecker U.Pedographic classification and ulcer detection in the diabetic foot[J].Foot Ankle Surg,2012,18(1):42-49.
[6]Patel M,McCormick K.Managing Diabetes in People with Foot Complications[M].Management of Diabetic Foot Complications:Spr inger,2015:39-49.
[7]Reekers J A,Lammer J.Diabetic Foot and PAD:The endovascular approach[J].Diabetes Metab Res Rev,2017,28(1):36-39.
[8]Lee KM,Kim WH,Lee JH,et al.Risk foctors of treatment failure in diabetic foot ulcer patients[J].Arch Plast Surg,2013,40(2):123-128.
[9]Richmond NA,Vivas AC,Kirsner RS.Topical and biologic therapies for diabetic foot ulcers[J].Med Clin North Am,2013,97(5):883-898.
[10]万凌.藻酸盐敷料对糖尿病足部窦道伤口治疗的疗效观察[J].吉林医学,2012,33(34):7498-7500.
[11]陈蔚.银离子敷料在糖尿病足感染伤口中的应用[J].中华现代护理杂志,2008,14(10):1178-1179.
[12]徐荣祥.MEBO-DFU再生疗法治疗糖尿病足的规范化流程[J].中国烧伤创疡杂志,2015,27(1):1-16.