皮肤减张器在儿童皮肤脓肿切开引流术后伤口愈合中的应用研究

Application of a novel zipper device in wound healing after incision and drainage of cutaneous abscesses in children

摘要

目的 评价皮肤减张器在儿童皮肤脓肿切开引流术后伤口愈合中的应用效果，并探讨其最佳干预时机。 方法 将2023年9月至2024年9月重庆医科大学附属儿童医院外科门诊就诊的皮肤脓肿患儿50例，按就诊日期的奇偶数分为2组，奇数日期就诊的26例为试验组；偶数日期就诊的24例为对照组，2 组均在脓肿切开引流术后，使用相同的抗感染敷料换药，待伤口渗液减少、基底出现新鲜肉芽组织时，试验组开始使用皮肤减张器对伤口进行逐渐拉拢闭合，对照组采用连续换药至伤口完全自然愈合。比较2组的伤口愈合时间、愈合速度及总换药费用；并通过线性回归及限制性立方样条曲线（restricted cubic spline，RCS），分析皮肤减张器的介入时间与伤口愈合时间之间的关系。 结果 与对照组相比，试验组的伤口愈合时间明显缩短、伤口愈合速度明显增快以及总换药费用也相对减少，差异有统计学意义（P<0.001）；多元线性回归模型显示皮肤脓肿感染范围的面积、皮肤减张器的介入时间与伤口愈合时间之间均存在较强相关性（P<0.05）；在RCS模型中，校正感染范围面积后的结果显示，皮肤减张器的介入时间与伤口愈合时间存在明显线性剂量反应关系（P_Nonlinear =0.406），伤口愈合时间随介入时间的缩短而缩短（P<0.001）。 结论 皮肤减张器对儿童皮肤脓肿切开引流后的伤口愈合有益，建议在伤口感染控制后尽早开始使用，以促进伤口的早期愈合。

Abstract

Objective To investigate the application effect of a novel zipper device in wound healing after incision and drainage of cutaneous abscesses in children，and to explore its optimal intervention timing. Methods A total of 50 children who attended the outpatient service of Department of Pediatric surgery from September 2023 to September 2024 were enrolled and divided into two groups according to the parity of the date of visit. The 26 children with the odd date of visit were enrolled as experimental group，and the 24 children with the even date of visit were enrolled as control group. The same anti-infective dressings were used for wound dressing in both groups after incision and drainage，and when there was a significant reduction in wound exudate and the fresh granulation tissue emerged at wound base，the zipper device was used for the children in the experimental group，and dressing change was performed for the children in the control group until the wound was completely healed. The two groups were compared in terms of wound healing time，healing rate，and the total costs of dressing change，and the multiple linear regression model and the restricted cubic spline （RCS） model were used to analyze the association between the intervention time of the zipper device and wound healing time. Results Compared with the control group，the experimental group had a significantly shorter wound healing time，a significantly higher wound healing rate，and significantly lower total costs of dressing change（P<0.001）. The multiple linear regression model showed that the infection size of skin abscess and the intervention time of the zipper device were strongly associated with wound healing time （P<0.05）. After adjustment for infection size，the RCS model analysis showed a significant linear dose-response relationship between intervention time and wound healing time （P_nonlinear=0.406），and wound healing time shortened with the reduction in intervention time （P<0.001）. Conclusion The application of the novel zipper device can help with the healing of cutaneous abscesses in children，and it is recommended to apply the device as early as possible after control of wound infection，in order to promote early wound healing.

关键词

皮肤减张器 / 儿童皮肤脓肿 / 伤口护理 / 限制性立方样条曲线

Key words

novel zipper device / cutaneous abscesses in children / wound care / restricted cubic spline

基金资助

第四批重庆医科大学附属儿童医院护理学科院级科研课题资助项目(CHCQMU2023.15)