比较新型硅橡胶负压冲洗引流系统与聚氨酯负压引流系统体外防堵塞性能的观察

doi:10.3877/cma.j.issn.1673-9450.2023.02.005

中华损伤与修复杂志(电子版) ›› 2023, Vol. 18 ›› Issue (02) : 116 -122. doi: 10.3877/cma.j.issn.1673-9450.2023.02.005

论著

比较新型硅橡胶负压冲洗引流系统与聚氨酯负压引流系统体外防堵塞性能的观察

翟延荣¹, 朱亚萍¹, 张秀珍¹, 钟晓娟¹, 鲁香月¹, 张雨凡¹, 陆树良²^,^†(

)

^1. 215128　苏州市吴中人民医院创面修复科
^2. 200025　上海交通大学医学院附属瑞金医院创面修复中心

收稿日期:2022-11-21 出版日期:2023-04-01
通信作者: 陆树良
基金资助:
江苏省苏州市科技计划项目(SKY2022033)

Comparison of the anti-blocking performance between the new silicone rubber negative pressure drainage instillation system and the polyurethane negative pressure drainage system in vitro

Yanrong Zhai¹, Yaping Zhu¹, Xiuzhen Zhang¹, Xiaojuan Zhong¹, Xiangyue Lu¹, Yufan Zhang¹, Shuliang Lu²^,^†()

^1. Department of Wound Repair, People′s Hospital of Wuzhong, Suzhou 215128, China
^2. Wound Repair Center, Ruijin Hospital, Shanghai Jiao Tong School of Medicine, Shanghai 200025, China

Received:2022-11-21 Published:2023-04-01
Corresponding author: Shuliang Lu

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引用本文：

翟延荣, 朱亚萍, 张秀珍, 钟晓娟, 鲁香月, 张雨凡, 陆树良. 比较新型硅橡胶负压冲洗引流系统与聚氨酯负压引流系统体外防堵塞性能的观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(02): 116-122.

Yanrong Zhai, Yaping Zhu, Xiuzhen Zhang, Xiaojuan Zhong, Xiangyue Lu, Yufan Zhang, Shuliang Lu. Comparison of the anti-blocking performance between the new silicone rubber negative pressure drainage instillation system and the polyurethane negative pressure drainage system in vitro[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(02): 116-122.

目的

体外比较新型硅橡胶防堵负压冲洗引流系统与传统聚氨酯负压引流系统的防堵塞性能。

方法

设计一种体外防堵实验，以PVC板模拟伤口表面，建立体外创面负压封闭引流模型，并制作了4种不同粘度的液体模拟不同创面的渗液及坏死组织，4种液体分别为：1号液体(0.9%生理盐水)、2号液体(混合均匀的生鸡蛋清)、3号液体(20 g蛋清加入200 ml 100℃的水中混匀)、4号液体(2号液体与3号液体1∶1混匀)，检测新型硅橡胶防堵负压冲洗引流管与传统聚氨酯负压材料在－50 mmHg至－300 mmHg负压条件下被4种液体体外灌洗后的堵塞情况。

结果

1~4号液体粘度分别为(1.16±0.01)mPa.S、(4.27±0.01)mPa.S、(1.26±0.02)mPa.S、(3.26±0.01)mPa.S；两种负压材料被4种液体灌洗后均出现不同程度的堵塞，负压明显减小(P<0.05)，其中1号液体组，在－50 mmHg至－175 mmHg条件下，两组负压材料堵塞程度差异无统计学意义(P>0.05)，但在－200 mmHg至－300 mmHg条件下聚氨酯负压材料组堵塞程度较防堵负压冲洗引流管组严重(P<0.05)；在2~4号液体组，防堵负压冲洗引流管组堵塞程度均较传统聚氨酯负压材料组明显减轻(P<0.05)。

结论

本课题组发明设计的新型硅橡胶防堵负压冲洗引流系统防堵效果佳，可应用于渗液粘稠、坏死组织较多的创面。

关键词: 负压伤口疗法, 聚氨酯, 管道堵塞, 防堵负压冲洗引流管

Objective

To compare the anti-blocking performance between the new silicone rubber negative pressure drainage instillation system and traditional polyurethane negative pressure drainage system in vitro.

Methods

An in vitro anti-blocking experiment was designed. Established an wound vacuum sealing drainage model in vitro and simulated the wound surface with PVC plates. Liquid 1 (0.9% saline), liquid 2 (raw egg white mixed evenly), liquid 3 (20 g egg white mixed in 200 ml of 100 ℃ water) and liquid 4 (liquid 2 and liquid 3 mixed in 1∶1) were used to simulate different exudates and necrotic tissues of the wound, and the blockage of the two groups of negative pressure materials after being irrigated by four kinds of liquids under negative pressure of -50 mmHg to -300 mmHg was detected.

Results

The viscosities of liquid 1 to liquid 4 were (1.16±0.01) mPa.S, (4.27±0.01) mPa.S, (1.26±0.02) mPa.S, (3.26 ± 0.01) mPa.S. After the two negative pressure materials were irrigated with four kinds of liquids, they were both blocked, and the negative pressure was significantly reduced (P<0.05). In the liquid 1 group, under the conditions of -50 mmHg to -175 mmHg, there was no statistically significant difference in the blocking degree of the two kinds of negative pressure materials (P>0.05), but under the conditions of -200 mmHg to -300 mmHg, the blocking degree of the polyurethane negative pressure material was more serious than that of the anti-blocking negative pressure drainage tube with instillation (P<0.05). In the liquid 2-4 groups, the traditional polyurethane negative pressure material was significantly higher than the anti-blocking negative pressure drainage tube with instillation (P<0.05).

Conluusion

The new silicone rubber negative pressure drainage instillation system invented and designed by our group has good anti-blocking effect and can be applied to wounds with thick exudate and nonviable tissue.

Key words: Negative pressure wound therapy, Polyurethane, Catheter obstruction, Anti-blocking negative pressure drainage tube with instillation

图1 防堵负压冲洗引流管结构图。1示主管体；2示冲洗通道；3示支撑柱；4示管接头；5示冲洗管；6示负压引流管

图2 防堵负压冲洗引流管实物图

图3 防堵负压冲洗引流管冲洗引流通路。1示冲洗液进入冲洗管；2示冲洗液进入主管体内的冲洗通道；3示冲洗液流出主管体的冲洗通道；4示冲洗液向周围扩散并冲洗创面；5示冲洗液、坏死组织、毒素被管接头收集；6示冲洗液、坏死组织、毒素自负压引流管排出体外

图4 4种液体的形态

图5 体外创面负压封闭引流的模型。A、B示以防堵负压冲洗引流管为核心的体外创面负压封闭引流装置的正面及底部；C、D示以聚氨酯负压材料为核心的体外创面负压封闭引流装置的正面及底部

表1 体外创面负压封闭引流模型在不同负压源下的初始负压P₀(mmHg，±s)

组别	样本数	中心负压源(mmHg)
组别	样本数	－50	－75	－100	－125	－150	－175	－200	－225	－250	－300
聚氨酯组	12	－50.56±0.42	－66.23±0.22	－92.39±0.41	－118.84±0.49	－145.62±0.85	－172.03±0.37	－198.73±0.52	－224.42±0.48	－250.58±0.52	－303.57±0.88
防堵组	12	－50.85±0.32	－66.41±0.25	－92.51±0.22	－119.10±0.21	－145.52±0.28	－171.80±0.50	－198.42±0.39	－224.12±0.37	－250.20±0.47	－303.00±0.88
t值		1.92	1.81	0.87	1.67	－0.39	－1.26	－1.69	－1.73	－1.89	－1.58
P值		0.068	0.084	0.392	0.115	0.705	0.219	0.105	0.098	0.072	0.129

表1 体外创面负压封闭引流模型在不同负压源下的初始负压P₀(mmHg，±s)

组别	样本数	中心负压源(mmHg)
组别	样本数	－50	－75	－100	－125	－150	－175	－200	－225	－250	－300
聚氨酯组	12	－50.56±0.42	－66.23±0.22	－92.39±0.41	－118.84±0.49	－145.62±0.85	－172.03±0.37	－198.73±0.52	－224.42±0.48	－250.58±0.52	－303.57±0.88
防堵组	12	－50.85±0.32	－66.41±0.25	－92.51±0.22	－119.10±0.21	－145.52±0.28	－171.80±0.50	－198.42±0.39	－224.12±0.37	－250.20±0.47	－303.00±0.88
t值		1.92	1.81	0.87	1.67	－0.39	－1.26	－1.69	－1.73	－1.89	－1.58
P值		0.068	0.084	0.392	0.115	0.705	0.219	0.105	0.098	0.072	0.129

图6 4种液体灌洗2种负压材料后的负压变化。A示4种液体灌洗聚氨酯负压材料后的负压变化；B示4种液体灌洗防堵负压冲洗引流管后的负压变化。P0为负压材料测压管处在不同中心负压条件下的初始压力；P1为4种液体灌洗负压材料后测压管处在不同中心负压条件下的实测压力

图7 4种液体模拟创面渗液后负压材料负压下降程度(ΔP)比较。A示聚氨酯组ΔP；B示防堵负压冲洗引流管组ΔP

图8 4种液体灌洗聚氨酯负压材料后负压下降程度与中心负压的关系

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Comparison of the anti-blocking performance between the new silicone rubber negative pressure drainage instillation system and the polyurethane negative pressure drainage system in vitro