Elastic Bandage Reduce the limb
In the orthopedic limbs surgery, it is well known that the surgical area and limb distal edema is more common, often due to edema caused by severe limb pain, incision infection, delayed healing and nonunion, our hospital since May 1999 with elastic bandage bandage incision And limb, made early control of limb edema, reduce limb pain, improve the wound healing effect of an early healing.
1 Materials and methods
1.1 cases of a total of 1032 cases of distal ulnar fractures in 263 cases, 171 cases of humeral fractures, femoral shaft fractures in 251 cases, 347 cases of tibia and fibula fractures, male 783 cases, female 249 cases, aged 3 to 85 years, mean 31.7 years old.
1.2 Treatment 1032 cases were randomly divided into treatment group and control group, the treatment group 711 cases, the use of elastic bandage from the limb (foot) refers to (toe) palm joint to the proximal dressing to the incision above 5cm, the control group 321 cases Routine incision dressing, all cases were routinely applied antibiotics and raise the limb, intravenous infusion of 25% mannitol 1.5g / kg, 1 / d, 1 to 9 days after the observation of the treatment results.
1.3 evaluation criteria Clinical edema is divided into [2: i ° ~ ⅲ °, i ° slightly swollen, but the striae exists; ⅱ ° edema was significantly associated with striae disappeared, but no blisters; ⅲ ° obvious swelling, and tension Sexual blisters. Edema i ° is effective, edema completely subsided for recovery.
2 treatment results
Results No edema cases were observed in the two groups. 95.6% of the patients in the control group showed ⅱ ° edema within 72 hours after operation. No treatment was seen in the treatment group. The curative effect of the treatment group was 89.59% and the total effective rate was 100%. The cure rate of the control group was 14.02% and the total effective rate was 77.26%. The average time of postoperative edema in the treatment group was For 3.5 days, while the average time of postoperative edema in the control group was 7.2 days, the difference between the two groups was very significant, p <0.01, see Table 1. Table 1 Comparison of the results of the two groups 3.1 The reasons for the emergence of edema [2,3 (1) due to surgical injury area around the body fluid circulatory system, resulting in tissue bleeding, body fluid reflux blocked, excessive body fluid retention in the formation of edema between tissues; Surgical post-traumatic pain and bedridden, the lack of active and passive exercise caused by lymphatic and venous return to reduce, causing excessive body fluid retention to increase local edema; (3) after surgery incision need to carry out sterile dressing dressing, dressing appropriate, (4) a large number of effusion in the postoperative area to further oppress the deep vein, so that the original in the excessive compensatory deep venous return to reduce the degree of edema. In general, the speed and extent of edema development depends on the degree of local dressing and the degree of trauma of the surgical site, 2h after the start of the obvious, 72h after the peak, dressing too loose is not conducive to pressure to stop bleeding, Oppression of the superficial vein venous obstruction, deep vein and surgical wound injury, tissue congestion caused by poor refraction, and limb arteries due to the role of arterial pressure was significantly less than the extent of the vein, due to venous obstruction caused by venous obstruction Pressure increased significantly due to hemodynamic reasons, limb capillary network in the internal and external vascular fluid exchange occurs more than the absorption, body fluid reflux disorder, severe cases can affect the limb blood circulation, leading to limb tissue ischemia Necrosis.
3.2 The mechanism of elastic bandage elastic bandage can even a certain pressure on the pressure parts, is conducive to surgical trauma and tissue pressure to stop bleeding, but also allows the limb for early functional exercise, in the course of its activities due to elastic bandage telescopic And the resulting resilience to the limb dressing parts play a similar role in massage extrusion, can promote blood circulation, improve or speed up the venous return, prevention and treatment of postoperative venous thrombosis effect, improve tissue ischemia, edema, accelerate edema Absorption, thereby reducing the incidence of edema [4 and to prevent the formation of subcutaneous hematoma. Therefore, the elastic bandage method is a good way to clinically apply orthopedics in orthopedics. It provides a new treatment for postoperative treatment of limbs and prevention of edema, thrombosis and early rehabilitation of postoperative patients.
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