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|本期目录/Table of Contents|

创伤性伤口患者皮肤清洗现况及原因的多中心横断面研究

《创伤外科杂志》[ISSN:/CN:]

期数:
2020年09期
页码:
646-650+654
栏目:
论著（软组织损伤）
出版日期:
2020-09-20

文章信息/Info

Title:
A multicenter cross-sectional study on the current situation and causes of skin cleaning in patients with traumatic wounds
作者:
蒋琪霞; 徐 娟; 刘晓晴; 李来娟; 白育瑄; 薛嘉宇; 彭 青; 黄秀玲; 谷 宇; 朱守林; 谭 挺
210002 南京,东部战区总医院烧伤整形科(蒋琪霞),门诊部伤口护理中心(薛嘉宇,彭青,黄秀玲,谷宇),卫勤部(谭挺); 223800 江苏 宿迁,南京鼓楼医院集团宿迁市人民医院骨科(徐娟); 210008 南京,南京大学医学院(刘晓晴); 222002 江苏 连云港,连云港第一人民医院伤口造口门诊(李来娟,朱守林); 325027 浙江 温州,浙江医鼎医用敷料有限公司临床学术部(白育瑄)
Author(s):
JIANG Qi-xia1; XU Juan2; LIU Xiao-qing3; LI Lai-juan4; BAI Yu-xuan5; XUE Jia-yu6; PENG Qing6; HUANG Xiu-ling6; GU Yu6; ZHU Shou-lin4; TAN Ting7
1.Department of Burns and Plastic Surgery,General Hospital of Eastern Theater Command,PLA,Nanjing 210002,China; 2.Department of Orthopedics,Suqian People's Hospital,Nanjing Gulou Hospital Group,Suqian,Jiangsu 223800,China; 3.Medical School of Nanjing University,Nanjing 210008,China; 4.Wound Stoma Clinic of Lianyungang First People's Hospital,Lianyungang,Jiangsu 222002,China; ...
关键词:
皮肤创伤;  伤口清洗;  伤口愈合;  横断面调查
分类号:
R 641
DOI:
10.3969j.issn.1009-4237.2020.09.002
文献标识码:
A
摘要:
目的 分析创伤性伤口患者皮肤清洗现况和存在的问题,为制定皮肤清洗方案、促进创伤愈合提供依据。方法 前瞻性设计横断面描述性研究及问卷,调查2020年1月18日—2月18日东部战区总医院门诊部、宿迁市人民医院骨科、连云港第一人民医院伤口门诊和外科病房的各类创伤性伤口患者,入选者经知情同意后自愿参与,通过手机“问卷星”调研问卷链接或二维码扫码完成在线问卷的调研及提交,内容包括人口学资料、居住情况、致伤原因、伤口气味和疼痛、活动能力、伤后皮肤清洁方法、每周清洗频率和每次清洗时间及不清洗的原因等。使用Epidata 3.0软件双人录入,核对建立数据库,SPSS软件分析患者的基本情况、伤口皮肤清洗现况及存在的问题。结果 剔除2份无效问卷,共收到391例有效数据问卷,男性、女性各占47.83%(187例)和52.17%(204例),年龄18～100岁,平均52.7岁。伤口持续时间<30d和≥30d者各占48.85%(191例)和51.15%(200例)。致伤原因:手术切口感染和物理性创伤各占55.50%(217例)和44.50%(174例)。活动能力:自主活动、轮椅活动和卧床分别占73.15%(286例)、9.97%(39例)和16.88%例(66例)。伤后清洗现况:伤后皮肤清洗率仅20.72%(81例,95%CI 16.70%～24.80%),清洗方法以包裹伤口淋浴和局部擦浴为主,分别占45.68%(37例)、44.44%(36例); 清洗频次每周1～2次,每次清洗时间10～15min; 皮肤和伤口不洁有异味者占33.50%(131例),其中不清洗者皮肤和伤口不洁有异味率明显高于清洗组(40.65% vs. 6.17%,P<0.05); 清洗率女性高于男性(P<0.05),年龄<65岁者≥65岁者活动自如者高于活动不便者(P<0.05)。310例不清洗原因主要为:听从医嘱39.67%(123例),担心感染56.13%(174例),失去自理能力4.20%(13例)。所有患者表示既担心皮肤清洗增加伤口感染风险,又担心不清洗局部污秽增加感染机会。结论 创伤性伤口患者皮肤清洗率总体较低,导致皮肤和伤口不洁发生率较高,需要根据年龄、性别和活动能力制定适宜的清洗方案。

参考文献/References

[1] 蒋琪霞.创伤性伤口感染处理现况及应对策略[J].创伤外科杂志,2019,21(6):401-404.
[2] Stewart KA,Groen RS,Kamara TB,et al.Traumatic injuries in developing countries: report from a nationwide cross-sectional survey of sierra leone[J].JAMA Surg,2013,148(5):463-469.
[3] Jiang BG,Liang S,Peng ZR,et al.Transport and public health in China: the road to a healthy future[J].Lancet,2017,390(10): 1781-1791.
[4] 付小兵,朱京慈,魏力.中华战创伤学(第11卷)战创伤护理与心理[M].郑州:郑州大学出版社,2016:3-4.
[5] Wuthisuthimethawee P,Lindquist S,Sandler N,et al.Wound management in disaster settings[J].World J Surg,2015,39(1):842-853.
[6] European Pressure Ulcer Advisory Panel,National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance.Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guideline.The International Guideline, 3rd Edition(2019)[EB/OL](2019-11-16)[2020-3-30].http://internationalguideline.com/static/pdfs/Quick_Reference_Guide-10Mar2019.pdf.
[7] Yu YH,Chao S,Lin YK,et al.The gap between currently available evidence and awareness in clinical practice of wound care: it is the time to shower earlier [J].Surgery,2018,164(1): 96-104.
[8] Groven FMV,Zwakhalen SMG,Schröder GO,et al.How does washing without water performcompared to the traditional bed bath: a systematic review[J].BMC Geriatrics,2017,17(1):31-47.
[9] Hsieh PY,Chen KY,Chen HY,et al.Postoperative showering for clean and clean-contaminated wounds[J].Ann Surg,2016,263(5):931-936.
[10] Dayton P,Feilmeier M,Sedberry S.Does postoperative showering or bathing of a surgical site increase the incidence of infection: a systematic review of the literature[J].J Foot Ankle Surg,2013,52(5):612-614.
[11] Friedstat J,Brown DA,Levi B.Chemical,electrical,and radiation injuries[J].Clin Plast Surg,2017,44(3):657-669.
[12] 蒋琪霞.伤口护理实践原则[M].3版.北京:人民卫生出版社,2017:142-200.
[13] 蒋琪霞,王建东,徐元玲,等.慢性伤口感染常见病原菌及其干预效果研究[J].护理学杂志,2015,30(12):19-26.
[14] 蒋琪霞,王建东,彭青,等.负压伤口治疗结合纳米银敷料处理创伤性慢性伤口的效果比较[J].医学研究生学报,2019,32(11):1198-1203.
[15] Malone M,Bjarnsholt T,Mcbain AJ,et al.The prevalence of biofilms in chronic wounds: a systematic review and meta-analysis of published data[J].J Wound Care,2017,26(1): 20-25.
[16] Fernandez R,Griffiths R.Water for wound cleansing[J].Cochrane Database Syst Rev,2012(2):CD003861.
[17] Sano H,Ichioka S.Which cleansing care is better,foot bath or shower: analysis of 236 limb ulcers[J].Int Wound J,2015,12(5):577-580.
[18] 蒋琪霞.压疮护理学[M].北京:人民卫生出版社,2015:18-50.
[19] Martin ET,Haider S,Palleschi M,et al.Bathing hospitalized dependent patients with pre-packaged disposable washcloths instead of traditional bath basins: a case-crossover study[J].Am J Infect Control,2017,45(9):990-994.
[20] Lee S,Fujimura H,Shimomura Y,et al.Verification of impact of morning showering and mist sauna bathing on human physiological functions and work efficiency during the day[J].Int J Biometeorol,2015,59(9):1207-1212.

备注/Memo

备注/Memo:
【基金项目】 全军卫勤创新能力专项课题(20WQ027); 上海王正国创伤医学发展基金会课题(WZGF20200101) 【通信作者】 谭挺,E-mail:dr.tanting@163.com
更新日期/Last Update: 2020-09-20