生物胶原纤维刘氏烧伤敷料的临床应用  

Clinical application of biological collagen fibers Liu's burn dressing

作　　者：刘炳森 李志刚[1] 刘红彬 王根法 周佳如 刘红社 刘俊英 史维刚 王培霞 

机构地区：[1]邯郸钢铁公司职工医院烧伤科,056001 [2]沙河市第二医院烧伤科,054100

出　　处：《中华损伤与修复杂志（电子版）》2010年第2期17-20,共4页Chinese Journal of Injury Repair and Wound Healing(Electronic Edition)

摘　　要：目的对生物胶原纤维刘氏烧伤敷料(LBD)进行临床疗效观察并探讨其应用前景。方法临床应用生物胶原纤维刘氏烧伤敷料治疗287例烧伤患者。对于新鲜浅二度或深二度烧伤创面红白相间,以红为主,特别是表皮撕脱创面,入院后,立即在清创室或床头覆盖LBD(不需麻醉),此组共125例;深二度烧伤创面以苍白为主或呈现表皮坏死型者,早期削磨痂不植皮应用LBD覆盖43例,三度烧伤早期切痂植皮(自体微粒或皮片)56例,肉芽植皮创面41例和供皮区22例。结果临床应用LBD早期覆盖新鲜烧伤创面后患者疼痛立即减轻,直观创面血浆渗出停止,休克期度过平稳,无一例因休克和脓毒症死亡。33例削痂创面中有8例削痂过深和10例削痂过浅,部分创面需通过换药或再补植皮治愈,其他15例在2周后上皮化,3～4周治愈,平均(21.0±1.2)d治愈。10例磨痂创面平均(20.1±21.0)d愈合。切痂创面3例微粒植皮,术后因未能按时去除外敷料,LBD发生溶解,创面通过换药治愈,5例部分创面形成肉芽(为原烧伤面积5%以下),经补植皮治愈,创面平均愈合时间(28.5±1.1)d。肉芽植皮创面愈合时间10～20d,10例需再补植皮,15例需换药治愈,创面平均愈合时间(14.2±1.3)d。供皮区创面愈合在7～11d,创面平均愈合时间(8.1±2.1)d。287例烧伤患者最大一次覆盖面积达90%,一次切痂和削磨痂最大面积分别为40%和85%。治愈出院280例,自动出院6例,死于败血症1例。结论生物胶原纤维刘氏烧伤敷料可广泛应用在各种烧伤创面,早期直接覆盖新鲜烧伤创面有保护创面、减少水分及血浆蛋白丢失的作用,对于预防休克和感染有较好疗效;对深二度削磨痂创面覆盖不需植皮,对三度切痂植皮创面可代替尸体皮,是理想的烧伤创面真皮替代覆盖物,可常规应用于烧伤创面。Objective To observe and discuss the clinical curative effect and the application prospect of the biological collagen fibers Liu＇s burn dressing （LBD）.Methods Two hundred and eighty seven burn patients were cured by LBD.Fresh shallow second-degree burns and the partial thickness burns with base wound showed majority of red spot lesions in red and white,on the cuticle tears especially after taking off the surface of wounds,which were immediately cleaned up in the wound room or covered on bedside（having no need of anaesthesia）by LBD after being hospitalized.There were 125 patients in total. Deep second-degree burn surface of a wound was mainly in white or showed cuticle.Early phase tangential excision or mill scab not making skin grafts applying LBD was done in 43 patients.Third-degree burn early escharectomy skin grafting（self microskin or skin slices）was done in 56 cases,granulation skin- grafting on surface of a wound in 41 cases,donor site in 22 cases.Results The patients with fresh empyrosis surface of a wound were covered early by LBD. All patients complained of immediate relief from pain and stopping of exoserosis on surface of wound.On shock period they had a smooth hospitalization and no death.In 33 cases who cut scab,8 cut scab in deep and 10 in the surface of a wound,and part surface of wound needed to be cured by changing fresh dressing or skin-grafting again,other 15 cases were epithelialize in 2 weeks,cured in 3-4 weeks,with the cure were cured time of the wound averaged（28.5±1.1）d.Ten patients with grind wound surface were cured（20.1±21.0）d on average. Escharectomy microskin-grafting was used in 3 cases,LBD was dissolved due to without timely removal of dressing,and wound was cured by changing dressing. Five patients were found part surfaces of wound and having granulation（less than 5%of origin burns）,cured by skin-grafting,with heal time averaged surface of wound in granulation skin grafting healed in 10-20 d,10 cases needing skin grafting again,other 15 cases requiring c

关 键 词：烧伤 生物敷料 生物胶原纤维敷料 

分 类 号：R644[医药卫生—外科学]