Ⅲ度烧伤面积≥90%患者创面处理的回顾  

Dealing with the burned wound in the patients with full-thickness burns TBSA≥90%:A retrospective analysis of 12 cases

作　　者：王德昌[1] 王一兵[1] 徐国士[2] 陈存富[3] 张科军 王明青[1] 薛文君[1] 霍然[1] 陈才远 邱明昕[2] 

机构地区：[1]山东大学临床医学院,山东省立医院烧伤整形外科,山东济南25002 [2]青岛市立医院 [3]济南军区总医院 [4]山东鲁南化肥厂医院 [5]烟台毓磺顶医院

出　　处：《实用医药杂志》2004年第11期968-970,共3页Practical Journal of Medicine & Pharmacy

摘　　要：目的回顾并探讨Ⅲ度烧伤面积≥90%患者的创面处理方法。方法对26年来12例Ⅲ度烧伤面积≥90%患者的Ⅲ度创面和深Ⅱ度创面的处理进行回顾性总结。烧伤早期或休克期切除Ⅲ度创面、异体皮覆盖、自体微粒皮移植;早期大面积切痂、戊二醛异体皮覆盖、替换更植自体皮;浸浴植皮;休克期磨痂等是处理本组患者Ⅲ度和深Ⅱ度创面的基本方法。头皮为主要供皮源。结果12例均治愈。8例生活自理,4例需部分护理依赖。结论早期切痂植皮是抢救成功Ⅲ度烧伤面积≥90%患者的关键措施;头皮皮源是抢救成功的重要因素。Objective To review and discuss the methods of dealing with the burned wound in the patients with full-thickness burns TBSA≥90%. Methods The data of dealing with the full-thickness burns and deep partial thickness burns in 12 patients with full-thickness burns TBSA≥90% in recent 26 years were summarized.Cutting the full-thickness burn wound at early period or during shock period, covering with cadaver skin and grafting with self-particulate skin;early excision of eschar,covering with glutaraldehyde allogeneic skin and then grafting of autologous skin; bathing and grafting with self-particulate skin; as well the abrasion during shock period were the basic methods disposing the full-thickness burns and deep partial thickness burns. Scalp was the main skin grafting resource.Results These 12 patients were all salvaged successfully; 8 patients can live by themselves, and the other 4 patients depend on nurse partly.Conclusion The pivotal measures of succeeding in salvaging the patients with full-thickness burns TBSA≥90% is cutting eschar and skin graft in early period;Using of scalp is an important factor for successful emergency treatment.

关 键 词：Ⅲ度烧伤面积≥90% 早期切痂 植皮 磨痂 头皮 

分 类 号：R644[医药卫生—外科学]