Kết quả không băng vết mổ sau phẫu thuật 48 giờ trong phẫu thuật sạch, sạch nhiễm vùng bụng tại Bệnh viện Đại học Y dược thành phố Hồ Chí Minh

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Tác giả: Thị Ngọc Sang Dương, Thị Phương Chinh Hoàng, Thị Hồng Anh Lê, Thị Kim Bích Lê, Thị Yến Linh Mai, Hàng Đăng Khoa Nguyễn, Thị Cẩm Nhung Nguyễn, Thị Thùy Dương Nguyễn, Thị Tuyết Hương Nguyễn, Long Bình Phạm, Minh Hải Phạm, Thúy Trinh Phạm, Thái Ngọc Huy Trần

Ngôn ngữ: vie

Ký hiệu phân loại: 617.2 Results of injuries and wounds

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2022

Mô tả vật lý: 64-70

Bộ sưu tập: Metadata

ID: 499215

Thêm vào giỏ

So sánh kết quả chăm sóc vết mổ ở những người bệnh có và không băng vết mổ sau phẫu thuật 48 giờ đối với vết mổ sạch, sạch nhiễm vùng bụng và chiều dài dưới 15cm. Phương pháp: Nghiên cứu thử nghiệm lâm sàng ngẫu nhiên có nhóm chứng. Kết quả: Trong thời gian từ tháng 10/2020 đến tháng 09/2021, tại Khoa Ngoại Gan-Mật-Tụy, Bệnh viện Đại học Y Dược TPHCM, có 44 trường hợp (TH) đƣợc chia ngẫu nhiên làm hai nhóm: nhóm can thiệp (nhóm không băng vết mổ sau 48h) có 24 TH, nhóm chứng (nhóm có băng vết mổ sau 48h) có 20 TH. Đau vết mổ (tính theo thang điểm VAS) ở nhóm can thiệp ít hơn nhóm chứng (2,5 ± 1,5 so với 3,45 ± 0,5, p=0,002). Sự thoải mái khi vệ sinh cơ thể ở nhóm can thiệp cao hơn nhóm chứng (4,29 ± 0,75 so với 2,6 ± 0,6, p<
0,001). Sự an tâm về lành vết mổ ở nhóm can thiệp cao hơn nhóm chứng (4,13 ± 0,79 so với 3,25 ± 0,79, p=0,001). Tổng chi phí chăm sóc vết mổ trong thời gian nằm viện (VNĐ) ở nhóm can thiệp thấp hơn nhóm chứng (183.900 ± 164.000 so với 1.035.000 ± 232.000, p <
0,001). Không có sự khác biệt về tỉ lệ nhiễm khuẩn vết mổ (4,55% so với 5%, p=0,970), tổng chi phí chăm sóc vết mổ sau xuất viện (VNĐ) (63.000 ± 208.000 so với 420.000 ± 295.000, p=0,187), thời gian nằm viện liên quan đến săn sóc vết thương (9,1 ± 3,13 so với 8,15 ± 2,60, p= 0,299) ở nhóm can thiệp và nhóm chứng. Kết luận: Không băng vết mổ sau phẫu thuật 48 giờ đối với vết thương sạch, sạch nhiễm vùng bụng là an toàn, khả thi. Có lợi hơn về một số phương diện như: giảm đau sau mổ, giảm chi phí chăm sóc vết mổ trong thời gian nằm viện và tăng sự hài lòng của bệnh nhân mà không làm tăng tỉ lệ nhiễm khuẩn vết mổ cũng như thời gian nằm viện.To compare the outcome of wound care in patients with and without bandage from 48 hours after the surgery in case of clean, clean-contaminated abdominal surgical wound and less than 15cm in length. Methods: Randomized controlled trial. Results: From October 2020 to September 2021, at the Hepatobiliary And Pancreatic Surgery Dept., University Medical Center, Ho Chi Minh City, Vietnam, 44 patients were randomly assigned to two groups: 24 cases in the intervention group (bandage removal within 48 hours of surgery) and 20 cases in the control group (bandage keeping beyound 48 hours of surgery). The post-operative pain (according to VAS) was lower in intervention group (2.5 ± 1.5 vs 3.45 ± 0.5, p=0.002). The patient's satisfaction on body hygiene was higher in intervention group (4.29 ± 0.75 vs 2.6 ± 0.6, p<
0.001). The patient's perception on recovering was higher in intervention group (4.13 ± 0.79 so với 3.25 ± 0.79, p=0.001). The total cost of inpatient wound care (VND) was lower in intervention group (183,900 ± 164,000 vs 1,035,000 ± 232,000, p <
0.001). There were no difference in the rate of surgical site infection (4.55% vs 5%, p=0.970), the total cost of outpatient wound care (63,000 ± 208,000 vs 420,000 ± 295,000, p=0.187), and the hospital stay (9.1 ± 3.13 vs 8.15 ± 2.60, p= 0.299) between two groups. Conclusion: Without bandage on surgical wound from 48 hours after the surgery in clean and clean-contaminated surgical wound care is safe, feasible. Its benefit was such as: reducing post-operative pain, total cost of inpatient wound care and increasing patient's satisfaction while the rate of surgical site infection and the length of hospital stay were similar.

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