载银磷酸锆纱布对烧伤创面常见细菌作用的实验研究

目的 了解载银磷酸锆纱布对烧伤大鼠创面感染常见细菌的抗菌效力。方法制作Wistar大鼠烫伤(以下称烧伤)感染模型，采用试管双倍稀释法测定载银磷酸锆及磺胺嘧啶银的最低抑菌浓度(MIC)及最低杀菌浓度(MBC)。观察大鼠创面用磺胺嘧啶银纱布、普通尢菌纱布、载银磷酸锆纱布(小水洗及水洗20次)后痂下组织的细菌计数和对创面愈合的作用。结果载银磷酸锆对金黄色葡萄球菌、铜绿假单胞菌、大肠竹菌的MIC各为8、8、16mg／L，MBC各为16、8、32mg／L，为磺胺嘧啶银的2～8倍?大鼠创面用未水洗的载银磷酸锆纱布覆盖后，痂下细菌计数比用磺胺嘧啶银纱布低91％，比普通无菌纱布低99％未水洗的载银磷酸锆纱布对创面愈合的作用明显优于其他两种纱布，且其痂下组织细菌计数与水洗20次的效银磷酸锆纱布比较，差异无显著性意义(P＞0．05)。结论载银磷酸锆埘烧伤创面感染常见细菌有较强的抑制和杀灭作用，其敷料可作为治疗措施中新的选择。     

不同方法治疗压褥的临床效果比较

目的探讨不同方法治疗压疮的临床效果。方法将65例患者计Ⅱ～Ⅲ度溃疡84处按基本条件相当原则随机分成A、B、C三组，A组21例28处，伤口采用清创冲洗后，给予康惠尔水胶体敷料；B组23例30处，伤口采用湿润烧伤膏；C组21例26处，清创冲洗后，给予自制凡士林油纱敷料外敷溃疡面处。结果B组愈合率最高，且平均显效时间和愈合时间均较A、C两组明显缩短，且A、B组明显高于C组。结论采用清创冲洗后用湿润烧伤膏是治疗压疮较好的方法之一。     

Throat pain and pharyngeal packing: a controlled randomized double-blind comparison between gauze and tampons

In order to determine whether patients having pharyngeal packing experience more or less post-operative throat pain when tampons were used, 80 patients were randomized into two groups to receive either gauze or tampon pharyngeal packing. A third control group of 40 patients were intubated but did not have any throat packs. Post-operative throat pain was subjectively rated at both 6 hours and at 24 hours by an independent observer. Thirty-eight per cent of patients had moderate or severe throat pain in the gauze group, whilst in the tampon and control groups these amounted to only 15% and 1% respectively. A significantly higher proportion of patients also had a moderate or severe sore throat at 24 hours in the former group. Intubation alone resulted in a sore throat post-operatively in 50% of patients, but 85% of those had a mild sore throat only. No differences in pain ratings in any group could be shown between men or women or between age groupings. Endotracheal intubation often causes post-operative throat pain which is exacerbated by the use of pharyngeal packing. The results presented suggest that tampons are a safe, effective alternative to gauze and result in less severe post-operative throat pain.     

采用纱球进行口腔护理的效果观察

目的探寻有效的口腔护理方法,取得更好的清洁口腔及洁牙效果。方法随机对53例有口腔护理适应症、意识清醒的患者,用纱球或棉球分别作左或右侧牙齿及口腔粘膜的清洁护理,并按同一标准进行效果评价。结果53例患者,以纱球擦洗侧,效果好的为42例,一般为11例,差为0例。以棉球擦洗侧,效果好为13例,效果一般为40例,差为0例,两组效果比较有显著性差异(P<0.01)。结论以纱球作口腔护理的清洁效果明显优于棉球的清洁效果。     

生肌膏药纱治疗慢性皮肤溃疡病

由于物理或化学因素引起皮肤创伤 ,皮肤创面形成以后 ,诸多原因(或感染 ,或异物 ,或血肿 ,或组织低流量血运不佳等 ) 使局部创面溃烂 ,创面增生和组织坏死液化交替、渗出 ,经久不愈。用中药制剂生肌膏制成膏剂药纱 ,外敷于皮肤疡面 ,收到满意的临床效果。     

不同止血方式在新生儿PICC置管后的效果观察

目的 探讨新生儿PICC置管后有效的止血方式及减少肢体肿胀的方法.方法 对在我科住院治疗的132例需置入PICC管的患儿,在常规护理的基础上随机分为实验组和对照组各66例.对照组采用2×2cm的纱块按压穿刺点,外部用折叠后的绷带缠绕加压;实验组采取我科自制的纱球,如花生米粒大小（约0.5×0.8cm）,用其按压穿刺点局部,然后在其外部以透明敷贴加压,观察两组患者穿刺点渗血情况以及肢体肿胀情况.结果 观察组在穿刺点止血及穿刺侧肢体肿胀方面明显优于对照组（P＜0.05）,两组差异具有统计学意义.结论 采用自制消毒纱球作点状按压能达到快速止血的效果并且能够减少肢体肿胀的发生.     

凡士林纱布覆盖修复足背部皮肤缺损

目的：探讨凡士林纱布覆盖修复足背部皮肤缺损的疗效。方法选取2010年3月~2012年3月我院收治的16例足背部皮肤缺损患者，清创后均给予凡士林纱布覆盖治疗，术后观察创面愈合程度、感染情况及皮肤感觉恢复情况。结果术后随访18个月，均达愈合标准，术后伤口感染1例，术后1年感觉基本恢复。结论凡士林纱布覆盖修复足背部皮肤缺损疗效确切，方法简单，安全，经济实惠。     

Intraconal gauze mass: An unusual complication of orbital fracture repair – a case report

Gossypiboma and textiloma are terms used to describe tumor-like masses caused by retained gauze or surgical sponges after any operation. It is a rare surgical complication, usually difficult to diagnose due to its variable clinical presentation and nonstandard radiological appearance. We describe here a rare case of orbital gossypiboma in a child after surgical correction of an orbital blowout fracture.     

Intra-abdominal packing with laparotomy pads and QuikClot™ during damage control laparotomy: A safety analysis

BackgroundIntra-abdominal packing with laparotomy pads (LP) is a common and rapid method for hemorrhage control in critically injured patients. Combat Gauze™ and Trauma Pads™ ([QC] Z-Medica QuikClot^®) are kaolin impregnated hemostatic agents, that in addition to LP, may improve hemorrhage control. While QC packing has been effective in a swine liver injury model, QC remains unstudied for human intra-abdominal use. We hypothesized QC packing during damage control laparotomy (DCL) better controls hemorrhage than standard packing and is safe for intracorporeal use.MethodsA retrospective review (2011–2014) at a Level-I Trauma Center reviewed all patients who underwent DCL with intentionally retained packing. Clinical characteristics, intraoperative and postoperative parameters, and outcomes were compared with respect to packing (LP vs. LP + QC). All complications occurring within the patients’ hospital stays were reviewed. A p ≤ 0.05 was considered significant.Results68 patients underwent DCL with packing; (LP n = 40; LP + QC n = 28). No difference in age, BMI, injury mechanism, ISS, or GCS was detected (Table 1, all p > 0.05). LP + QC patients had a lower systolic blood pressure upon ED presentation and greater blood loss during index laparotomy than LP patients. LP + QC patients received more packed red blood cell and fresh frozen plasma resuscitation during index laparotomy (both p < 0.05). Despite greater physiologic derangement in the LP + QC group, there was no difference in total blood products required after index laparotomy until abdominal closure (LP vs LP + QC; p > 0.05). After a median of 2 days until abdominal closure in both groups, no difference in complications rates attributable to intra-abdominal packing (LP vs LP + QC) was detected.ConclusionWhile the addition of QC to LP packing did not confer additional benefit to standard packing, there was no additional morbidity identified with its use. The surgeons at our institution now select augmented packing with QC for sicker patients, as we believe this may have additional advantage over standard LP packing. A randomized controlled trial is warranted to further evaluate the intra-abdominal use of advanced hemostatic agents, like QC, for both hemostasis and associated morbidity.