摘要
目的探讨深度烧伤创面采用负压封闭引流技术(VSD)进行皮肤修复治疗的临床效果。方法回顾性分析2017年6月至2018年6月在我院治疗的100例Ⅱ、Ⅲ度深度烧伤患者的临床资料,根据不同治疗方法分为观察组与对照组,每组50例。对照组采用削痂植皮治疗,加压包扎植新皮区;观察组行削痂植皮术联合VSD进行治疗。观察并比较2组患者的住院时间、总医疗费用、创面感染率及植皮存活率等。结果对照组与观察组细菌培养阳性率分别为78.0%和24.0%,2组比较差异有统计学意义(χ^2=29.172,P<0.001);对照组与观察组首次植皮存活率分别为74.0%与90.0%,2组比较差异有统计学意义(χ^2=4.336,P=0.037);对照组疼痛评分为(6.9±2.30)分,观察组疼痛评分为(5.7±2.12)分,2组比较差异有统计学意义(t=5.336,P<0.05);对照组患者住院时间为(31.6±7.1)d,观察组为(22.6±5.73)d,2组比较差异具有统计学意义(t=5.897,P=0.000);观察组和对照组患者住院医疗费用分别为(3.79±0.91)万元和(3.86±0.74)万元,差异无统计学意义(t=2.496,P=0.069)。结论Ⅱ、Ⅲ度深度烧伤患者采用VSD治疗有利于创面愈合,可降低感染率,减轻患者疼痛,提高植皮存活率。
Objective To study the clinical effect of vacuum sealing drainage(VSD) in the treatment of skin repair with deep burn wounds. Methods The clinical data of 100 patients with deep burns of grade Ⅱ and Ⅲ in our hospital from June 2017 to June 2018 were retrospectively analyzed.According to different treatment methods,the patients were divided into the observation group and the control group,50 cases in each group.The control group were treated with tangential excision and skin grafting,and pressure banding of the new skin area.The observation group were treated with tangential excision and skin grafting combined with VSD.The hospitalization time,total medical costs,wound infection rate and skin graft survival rate between the two groups were observed and compared. Results The positive rates of bacterial culture in the control group and the observation group were 78.0% and 24.0%,respectively,the difference was statistically significant(χ^2=29.172, P <0.001).The first skin graft survival rate of the control group and the observation group were respectively 74.0% and 90.0%,the difference was statistically significant(χ^2=4.336, P =0.037).The pain score of the control group was (6.9±2.30), and that of the observation group was (5.7±2.12),the difference was statistically significant( t =5.336, P <0.05).The hospitalization time of the control group was (31.6±7.1)days,the observation group was (22.6±5.73)days,the difference was statistically significant( t =5.897, P =0.000).There was no significant difference in hospitalized costs of obeservation group(37 900.2±9 124.3) yuan and control group (38 654.1± 7 432.8 ) yuan( t =2.496, P =0.069 ). Conclusion For patients with deep burns of grade Ⅱ and Ⅲ,the treatment combined with VSD can promote the wound healing,reduce the incidence of infection and the pain of patients,and greatly improve the survival rate of skin grafting.
作者
罗兴前
郭杏
周虹
廖筱梅
谭美云
LUO Xing-qian;GUO Xing;ZHOU Hong;LIAO Xiao-mei;TAN Mei-yun(Department of Plastic and Burn Surgery,First Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China;Department of Orthopaedic Surgery,First Affiliated Hospital of Southwest Medical University,Luzhou Sichuan 646000,China)
出处
《局解手术学杂志》
2019年第7期569-572,共4页
Journal of Regional Anatomy and Operative Surgery
关键词
负压封闭引流技术
深度烧伤
皮肤移植
削痂
vacuum sealing drainage
deep burn
skin grafting
tangential excision
