Intestinal fistula is a serious complication after gastrointestinal surgery. Intestinal fistula can not only cause disorder of water, electricity and acid-base balance, nutrient absorption disorder, but also serious abdominal infection and even systemic infection. Once intestinal fistula occurs, a large amount of intestinal fluid flows out of the fistula to contaminate the incision, dressing, bedding, etc., it is necessary to change the dressing in time, clean the wound, and increase the nursing workload. The skin around the fistula is also eroded, painful, and infected due to the erosion of intestinal fluid and stool, which brings great pain and heavy economic burden to patients.
1. Mechanism of foam dressing in the treatment of intestinal fistula complicated with infection
Closed negative pressure drainage is a technique for the treatment of acute and chronic wounds. It was pioneered by a German doctor in 1992 and was originally used to treat soft tissue infection wounds of the trunk and limbs. Its application effect was quickly confirmed, and it was gradually recommended to the wounds with various problems after trauma, such as chronic and unhealed ulcer wounds, large-scale soft tissue injury wounds, and wounds in special parts (head, hand, perineum) clinical treatment under treatment.
Foam dressing as health medical supplies is constructed of conformable polyester foam covered with a highly breathable film backing. It can increase local skin oxygen partial pressure, improve skin blood circulation, reduce tissue dehydration, effectively disperse the pressure on the stressed part, and facilitate the growth of epithelial cells and granulation tissue. Foam dressing does not adhere to the new granulation tissue, does not damage the new tissue when changing the dressing. It reduces local pain and bleeding, and the special foam can absorb a large amount of exudate, prolong the dressing change interval, and significantly reduce the number of dressing changes. The film backing is a new type of transparent dressing, which is smooth, waterproof, breathable and less prone to skin allergies. It can be used as a barrier for external pollution to prevent the stimulation and pollution of the skin of the pressure ulcer by blood, body fluids, secretions, excreta, etc. Foam dressing is used clinically on patients with pressure ulcers and poor healing of wound exudate. The price is affordable and patients are more acceptable.
2. Nursing care of foam dressing in the treatment of intestinal fistula complicated with infection
Most of the intestinal fistulas occur because the intestinal function is not restored in the early postoperative period, the local repair or anastomotic effect is not satisfactory, and tissue inflammation, edema, ischemia, etc. occur, thereby causing lateral leakage. Therefore, timely and effective drainage, infection control, acid-base balance maintenance, parenteral nutrition, and monitoring of vital organ function are required. In the nursing process of using foam dressing products to treat intestinal fistula complicated with infection, it is found that continuous negative pressure value is suitable, and the effect is the best. In operation, we use the Sman peak electric negative pressure suction treatment instrument compared with the wall-type central negative pressure suction, the pressure is relatively constant, and the negative pressure can be adjusted automatically. There is no need to worry about the damage to the wound tissue if the pressure is too high. If the pressure is too low, it will not be able to effectively drain the wound, which will easily cause the blockage of the pipeline.
Generally, patients with intestinal fistula and wound infection and poor healing are mostly critically ill patients. The use of closed negative pressure suction with constant pressure can reduce the number of dressing changes and bed sheet changes, reduce moving patients, and reduce skin erosion and pain around the wound. Foam dressing as health medical supplies are affordable, easily accepted by patients, and lighten the financial burden. It reduces workload for medical staff and increases patient satisfaction.