控制性清创后应用生物辅料及表皮细胞种植修复深Ⅱ度烧伤创面  

Treatment of deep second-degree burn wounds with the combination of biological dressing and epidermal cell implantation after controlled debridement

作　　者：石雪芹 周琴 胡大海 王耘川 谢松涛 何亭 刘苗苗 屈艳艳 王佳妮 Shi Xueqin;Zhou Qin;Hu Dahai;Wang Yunchuan;Xie Songtao;He Ting;Liu Miaomiao;Qu Yanyan;Wang Jiani(Department of Burns and Cutaneous Surgery,Xijing Hospital,Air Force Medical University,Xi’an 710032,Shaanxi Province,China)

机构地区：[1]空军军医大学西京医院全军烧伤中心烧伤与皮肤外科

出　　处：《中国组织工程研究》2020年第17期2730-2734,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81601689)，项目负责人：何亭;国家级重大公益性卫生行业科研专项(201502015)，项目负责人：胡大海;临床助推计划-自由探索项目(XJZT18ML29)，项目负责人：周琴~~

摘　　要：背景:针对目前深Ⅱ度烧伤创面治疗修复方法多样,效果不一,缺乏规范与统一,有必要开发的新技术。目的:观察控制性清创与传统型方法对深Ⅱ度烧伤创面的治疗效果。方法:2015年6月至2018年6月共入选80例深Ⅱ度烧伤患者,分成阳性对照组和控制性清创组进行研究,每组40例。阳性对照组外涂邦尔康烧伤抑菌霜,油纱覆盖加压包扎,分别于伤后第3,6,9,12天换药;控制性清创组按创面制备要求,制备表皮细胞悬液,喷洒至创面,用Recell套装自带保护膜覆盖创面,术后第3天打开保持干燥,随后观察术后第6,9,12天创面情况。该研究得到空军军医大学西京医院伦理委员会的批准,所有患者均自愿参加,知情并签署知情同意书。采用在线登记患者信息,并根据随机(软件在线提供)分组治疗方案进行相应治疗准备。结果与结论:控制性清创组创面细菌含量、创面疼痛评分、创面感染评分、促炎性因子水平明显低于阳性对照组,差异有显著性意义(P<0.05),且均未发生不良反应。该结果表明,表皮细胞种植技术结合控制性清创用于深Ⅱ度创面的治疗方案具有促进创面愈合、减轻感染、降低患者痛苦的作用,效果显著。BACKGROUND:There are various methods for the treatment and repair of deep second-degree burn wounds,which have diverse effects and have no uniform standards.Therefore,new technologies need to be developed.OBJECTIVE:To observe the therapeutic effect of controlled debridement and traditional treatment on deep second-degree burn wounds.METHODS:A total of 80 patients with deep second-degree burns from June 2015 to June 2018 were enrolled and divided into a positive control group and a controlled debridement group,with 40 patients in each group.The positive control group was coated with Bangerkang burn bacteriostatic cream,and the oil gauze was pressure-wrapped.The dressing was changed at 3,6,9,and 12 days after the injury.In the controlled debridement group,epidermal cell suspension was prepared according to the requirements of wound preparation and was sprayed onto the wound surface.The wound was then covered with Recell Kit self-contained protective film.The film was removed to keep the wound dry on the 3rd day after operation,and then the wound was observed at 6,9,and 12 days after operation.The study protocol was approved by the Ethics Committee of the Xijing Hospital of the Air Force Military Medical University.All patients volunteered to participate in the study and sign an informed consent.Patient information was registered online and appropriate treatment was performed according to a random(software online)assignment.RESULTS AND CONCLUSION:At 3,6,9,and 12 days after operation,the bacterial content,wound pain score,wound infection score and pro-inflammatory factor level in the controlled debridement group were significantly lower than those in the positive control group(P<0.05).Moreover,there was no complication in both groups.These findings reveal that epidermal cell implantation combined with controlled debridement for deep second-degree burn wounds can achieve remarkable outcomes,which can significantly accelerate wound healing,reduce infection and alleviate the suffering of patients.

关 键 词：烧伤 深Ⅱ度创面 控制性清创 生物敷料 表皮细胞 

分 类 号：R459.9[医药卫生—治疗学] R394.2[医药卫生—临床医学]