比較不同傷口換藥溶液之成效－以冠狀動脈繞道手術病患腿部取血管處傷口為例

Comparison of the Effectiveness of Different Wound Solutions in the Treatment of a Saphenous Vein Harvest Wound

顏芳慧(Fang-Hui Yen) ； 葉玫伶(Mei-Lin Yeh)

《實證護理》 1卷2期 (2005/06) Pp. 90-100

https://doi.org/10.6225/JEBN.1.2.90

摘要

本研究目的為比較不同傷口換藥溶液之成效，樣本取自於南部某醫學中心38位（40組傷口樣本）冠狀動脈繞道手術病患。採實驗研究之二組時間序列設計，取病患腿部大隱靜脈二處獨立外科傷口，隨機分派以無菌生理食鹽水（實驗組）及水溶性優碘（對照組），作為術後第一至七天傷口換藥溶液，觀察傷口癒合、傷口感染、換藥時個案自覺疼痛得分，及不同換藥溶液之成本花費之差異。資料分析以EPI-INFO統計軟體進行描述性分析，及SAS統計軟體之重覆測量分析兩組間效果變項差異。研究結果顯示：(1)傷口癒合及傷口感染得分部分，兩者在統計上無顯著差異，表示傷口不因使用生理食鹽水換藥而延遲癒合或增加感染機率；(2)換藥時個案自覺疼痛得分以使用生理食鹽水之傷口疼痛得分較低，但與水溶性優碘並未達到統計上之顯著差異；(3)換藥成本耗材方面，使用生理食鹽水作為換藥溶液時其花費僅為水溶性優碘的二分之一。依本研究所得之結果，建議日後在一般外科清潔傷口換藥時，可使用生理食鹽水代替水溶性優碘。

關鍵字

傷口換藥 ； 無菌生理食鹽水 ； 水容性優碘 ； 冠狀動脈繞道手術 ； 大隱靜脈取血管處傷口

並列摘要

The purpose of this study was to compare the effects (including wound healing, wound infection, and wound pain) of sterile normal saline and povidone-iodine on saphenous vein harvest incision wounds, following coronary artery bypass surgery. Thirty-eight (from a sample of forty pairs) CABG patients were enlisted at a medical center in Kaohsiung. The experiment was based on random sampling with repeated measure experimental design. Each harvest wound of the saphenous vein was randomly assigned to be treated with either sterile normal saline or povidone-iodine in the first 7 days after operation. The major statistics applied in data management were descriptive statistics and Generalized Estimating Equations (GEE). The results indicated that there is no significant difference between these two groups in wound healing scores and wound infection scores. In a comparison of wound pain scores on dressing changes, sterile normal saline scored lower than povidone-iodine, but there was no significant difference between the two. Because the cost of povidone-iodine solution is double that of sterile normal saline, we suggest that sterile normal saline is a better option than povidone-iodine for the cleansing of surgical wounds.

並列關鍵字

change dressing ； sterile normal saline ； povidone-iodine ； coronary artery bypass graft surgery ； saphenous vein harvest incision wound