Clinical efficacy of modified vacuum-sealing drainage in treatment of perianal necrotizing fasciitis

doi:10.3877/cma.j.issn.2095-3224.2019.01.010

Abstract

Abstract:

Objective

To evaluate the clinical effects of modified vacuum-sealing drainage (VSD) technology in the treatment of perianal necrotizing fasciitis.

Methods

Sixty patients with perianal necrotizing fasciitis admitted to Shiyan Taihe Hospital from July 2010 to January 2017 were selected as the research subjects. Sixty patients were divided into the observation group and the control group randomly, each group has 30 patients. The observation group was treated by continuous modified VSD, and the control group was treated by conventional debridement. To compare the clinic efficacy of two group.

Results

Comparing with the control group, the average debridement times (t=24.587, P=0.000), the wound healing times (t=7.841, P=0.000), the hospitalization time (t=-4.797, P=0.000), the hospitalization expenses (t=57.753, P=0.000) were lower. The score of Visual Analogue Scale on 3 d (t=9.115, P=0.000), 7 d (t=7.174, P=0.000), 14 d (t=-3.415, P=0.002) and Fournier′s gangrene severity index (FGSI) on 3 d (t=2.036, P=0.046), 7 d (t=2.208, P=0.031), 14 d (t=-4.415, P=0.000) in the observation group decreased obviously. The difference between the experiment group and the control group had statistical significance (P<0.05). There were no difference between the two group at the aspect of recurrence rate of pirianal abscess (χ²=0.472, P=0.642) and anal fistula (χ²=1.041, P=0.323).

Conclusion

The debridement combined with modified VSD is an effective method for the treatment of perianal necrotizing fasciitis and is worthy of clinical application.

Key words: Anal canal, Abscess, Perianal necrotizing fasciitis, Modified vacuum-sealing drainage, Clinic efficacy

Yan Fu, Zibing Wang, Bing Zhang, Qiuju Chen, Hui Li, Heng Li. Clinical efficacy of modified vacuum-sealing drainage in treatment of perianal necrotizing fasciitis[J]. Chinese Journal of Colorectal Diseases(Electronic Edition), 2019, 08(01): 54-57.

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Figures/Tables 1

References 19

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临床观察项目	观察组	对照组	检验值	P值
清创换药次数	4.7±1.1	31.2±5.8	t=24.587	<0.001
愈合时间	18.2±3.6	26.2±4.2	t=7.841	<0.001
住院时间	22.7±3.8	28.7±5.7	t=-4.797	<0.001
住院费用	11870±1120	20120±2410	t=-57.753	<0.001
脓肿复发［n（%）］	2（6.6）	3（10.0）	χ²=0.472	0.642
肛瘘形成［n（%）］	1（3.3）	3（10.0）	χ²=1.041	0.323
VAS（术前）	8.2±1.3	8.3±1.1	t=0.341	0.726
VAS（术后第3 d）	4.3±1.2	7.9±1.8	t=9.115	<0.001
VAS（术后第7 d）	3.2±1.5	5.8±1.3	t=7.174	<0.001
VAS（术后第14 d）	2.3±1.1	3.3±1.4	t=-3.415	0.002
FGSI（术前）	5.7±1.1	5.6±0.9	t=0.385	0.702
FGSI（术后第3 d）	4.9±0.9	5.4±1.0	t=2.036	0.046
FGSI（术后第7 d）	4.3±1.3	5.1±1.5	t=2.208	0.031
FGSI（术后第14 d）	3.1±1.1	4.6±1.3	t=-4.415	<0.001

临床观察项目	观察组	对照组	检验值	P值
清创换药次数	4.7±1.1	31.2±5.8	t=24.587	<0.001
愈合时间	18.2±3.6	26.2±4.2	t=7.841	<0.001
住院时间	22.7±3.8	28.7±5.7	t=-4.797	<0.001
住院费用	11870±1120	20120±2410	t=-57.753	<0.001
脓肿复发［n（%）］	2（6.6）	3（10.0）	χ²=0.472	0.642
肛瘘形成［n（%）］	1（3.3）	3（10.0）	χ²=1.041	0.323
VAS（术前）	8.2±1.3	8.3±1.1	t=0.341	0.726
VAS（术后第3 d）	4.3±1.2	7.9±1.8	t=9.115	<0.001
VAS（术后第7 d）	3.2±1.5	5.8±1.3	t=7.174	<0.001
VAS（术后第14 d）	2.3±1.1	3.3±1.4	t=-3.415	0.002
FGSI（术前）	5.7±1.1	5.6±0.9	t=0.385	0.702
FGSI（术后第3 d）	4.9±0.9	5.4±1.0	t=2.036	0.046
FGSI（术后第7 d）	4.3±1.3	5.1±1.5	t=2.208	0.031
FGSI（术后第14 d）	3.1±1.1	4.6±1.3	t=-4.415	<0.001

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