Clinical effect of low temperature plasma ablation debridement combined with vacuum sealing drainage in treatment of postoperative abdominal wall incision infection
Objective:To explore the clinical effect of low temperature plasma ablation (LTPA) debridement combined with vacuum sealing drainage (VSD) in the treatment of postoperative abdominal wall incision infection.Methods:A retrospective cohort study was carried out to analyze the clinical data of 99 patients diagnosed with postoperative abdominal wall incision infection who were admitted to the First Medical Center of the General Hospital of the People's Liberation Army from January 2011 to September 2021, including 61 males and 38 females with a mean aged of (39.1±2.3) years. According to the treatment method, the patients were divided into either an LTPA combined with VSD group (47 cases) or a VSD alone group (52 cases). Preoperative and postoperative bacterial culture results, wound healing rate, pain score, and adverse reaction rate of the two groups were analyzed.Results:The positive rate of bacterial culture in the combination group was 100% (47/47), 2.1% (1/47), 0% (0/47), and 0% (0/47), respectively, before operation and at the first, second, and third VSD replacement, and it was 100% (52/52), 65.4% (34/52), 21.2% (11/52), and 0% (0/52) in the VSD alone group, respectively; the positive rate in the LTPA+VSD group at the first and second replacement of VSD was both significantly lower than that in the VSD group at the corresponding time points (P＜0.05 for both). The wound healing rate of the LTPA+VSD group after the first, second, and third treatment was 58.2%±11.0%, 71.6%±10.1%, and 91.7%±11.8%, respectively, and it was 43.5%±12.4%, 62.3%±11.5%, and 75.2%±10.3% in the VSD alone group, respectively; the wound healing rate in the LTPA+VSD group at each time point was all significantly higher than that in the VSD group (P＜0.05 for all). The time of complete wound healing in the LTPA+VSD group was (28.5±6.4) days, which was significantly shorter than that in the VSD group [(55.3±6.5) days; P＜0.001]. The VAS score of the two groups before the first treatment was 5.5±1.6 and 5.4±1.5, respectively (P＞0.05). The VAS score at 10 days after the first treatment in the LTPA+VSD group was 1.1±0.5, which was significantly lower than that in the VSD group [(3.5±0.9), P＜0.001]. The incidence of postoperative adverse reactions in the VLTPA+VSD group was 4.3%, which was significantly lower than that in the VSD group (19.2%, P＜0.05).Conclusion:LTPA+VSD in the treatment of postoperative abdominal wall incision infection has the advantages of effectively reducing the positive rate of wound bacterial culture, accelerating wound healing, reducing postoperative pain, and avoiding postoperative adverse reactions.
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