一期负压封闭引流结合二期植皮修复深度烧伤创面疗效探讨  

Effect of Vacuum Sealing Drainage Combined with Skin Grafting on Deep Burn Wounds

作　　者：郑林文 郑建军 陈昭宏[1] ZHENG Lin-wen;ZHENG Jian-jun;CHEN Zhao-hong(Department of Burn,Union Hospital Affiliated to Fujian Medical University,Fuzhou 350001,Fujian,China)

机构地区：[1]福建医科大学附属协和医院烧伤科,福建福州350001

出　　处：《中国美容医学》2021年第8期22-24,170,共4页Chinese Journal of Aesthetic Medicine

基　　金：福建医科大学启航基金(编号:2019QH1184)。

摘　　要：目的:探讨一期负压封闭引流(Vacuum sealing drainage,VSD)结合二期植皮术对深度烧伤患者的治疗效果。方法:选取笔者医院2019年1月-2020年3月收治的深度烧伤患者66例,将所有患者采用随机数字表法分为对照组与观察组,对照组(n=32)采用一期传统换药治疗联合二期植皮治疗,观察组(n=34)采用一期VSD结合二期植皮治疗,观察比较两组患者创面愈合时间、住院时间、术后感染情况、创面封闭成功率、疼痛程度以及瘢痕增生程度。结果:观察组创面愈合时间及住院时间均显著少于对照组,差异有统计学意义(P<0.05)。观察组术后创面感染率以及肺部感染率分别为2.94%和0.00%,显著低于对照组(18.75%,12.50%),差异有统计学意义(P<0.05)。观察组患者创面封闭成功率(85.29%)显著高于对照组(53.13%),差异有统计学意义(P<0.05)。术后7d以及末次随访,观察组疼痛程度评分均显著低于对照组,差异有统计学意义(P<0.05)。观察组重度瘢痕增生仅8.82%,显著低于对照组的53.13%,差异有统计学意义(P<0.05)。结论:一期VSD结合二期植皮术治疗深度烧伤患者时能够显著减少创面感染的发生、减轻患者疼痛、缩短愈合时间以及住院时间,同时减少后期瘢痕的增生,值得临床进一步推广使用。Objective To investigate the therapeutic effect of vacuum sealing drainage(VSD)combined with secondary skin grafting on deep burn patients.Methods 66 cases of deep burn patients in our hospital from January 2019 to March 2020 were selected and randomly divided into the control group and the observation group.The control group(n=32)was treated with one-stage traditional dressing change combined with two-stage skin grafting,and the observation group(n=34)was treated with one-stage VSD combined with two-stage skin grafting Postoperative infection,wound closure success rate,degree of pain and degree of scar hyperplasia.Results The wound healing time and hospital stay in the observation group were significantly less than those in the control group,the differences were statistically significant(P<0.05).The postoperative wound infection rate and lung infection rate in the observation group were 2.94%and 0.00%respectively,which were significantly lower than those in the control group(18.75%and 12.50%,P<0.05).The success rate of wound closure in the observation group(85.29%)was significantly higher than that in the control group(53.13%,P<0.05).On the 7th day after operation and the last follow-up,the pain score of the observation group was significantly lower than that of the control group(P<0.05).Severe scar hyperplasia in the observation group was only 8.82%,significantly lower than that in the control group(53.13%,P<0.05).Conclusion One stage VSD combined with two-stage skin grafting in the treatment of deep burn patients can significantly reduce the occurrence of wound infection,relieve pain,shorten the healing time and hospitalization time,and reduce the scar hyperplasia in the later stage,which is worthy of further clinical application.

关 键 词：负压封闭引流技术 植皮修复 联合治疗 深度烧伤 创面愈合 瘢痕增生 

分 类 号：R644[医药卫生—外科学]