水动力清创系统对大面积烧伤残余创面愈合及炎症因子的影响  

Effect of Hydrodynamic Debridement System on Residual Wound Healing and Inflammatory Factors in Large Area Burns

作　　者：项俊 吴红[1] XIANG Jun;WU Hong(Department of Burns,Tongren Hospital of Wuhan University,Wuhan Third Hospital,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学附属同仁医院暨武汉市第三医院烧伤科,湖北武汉430060

出　　处：《中国美容医学》2021年第10期25-28,共4页Chinese Journal of Aesthetic Medicine

基　　金：湖北省卫生健康委员会科研项目(编号:WJ2019M003);武汉市医学科研项目(编号:WG19B02)。

摘　　要：目的:探讨水动力清创系统对大面积烧伤残余创面愈合及炎症因子的影响,总结分享笔者医院治疗大面积烧伤残余创面的临床经验。方法:选取2017年3月-2020年3月笔者医院收治的大面积烧伤残余创面修复治疗的56例患者作为研究对象,根据其采取的不同治疗方式分为对照组(30例)和观察组(26例)。入院后均给予抗休克、抗感染、全身营养支持等治疗。对照组采用传统清创,观察组采用水动力清创系统对创面进行清创。记录并计算两组创面清创时间、皮片成活率、创面愈合时间、创面细菌培养阳性率、再次清创率。检测两组清创前及清创后7d,血清C反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)水平。结果:观察组清创时间、创面愈合时间均低于对照组,皮片成活率高于对照组,差异有统计学意义(P<0.05)。观察组细菌培养阳性率、再次清创率均低于对照组,差异有统计学意义(P<0.05)。清创后7d,两组血清CRP、PCT水平均低于清创前,且观察组均低于对照组,差异有统计学意义(P<0.05)。结论:采用水动力清创系统对大面积烧伤残余创面清创能够有效提高清创效率,节约手术时间,有利于创面愈合,提高皮片成活率,还能够有效避免细菌感染,减少手术清创次数,减轻创面炎症反应,值得推广。Objective To explore the effect of hydrodynamic debridement system on the healing of large-area burn residual wounds and inflammatory factors,and to summarize and share our hospital’s clinical experience in treating large-area residual burn wounds.Methods 56 patients admitted to our hospital from March 2017 to March 2020 for the treatment of large area burn residual wounds were selected as research objects,and were divided into the control group(n=30)and the observation group(n=26)according to their different treatment methods.After admission,they were given treatments such as anti-shock,anti-infection,and systemic nutritional support.The control group used traditional debridement,and the observation group used the hydrodynamic debridement system to debride the wound.Record and calculate the wound debridement time,skin survival rate,wound healing time,positive rate of wound bacterial culture,and re-debridement rate.The levels of serum C-reactive protein(CRP)and procalcitonin(PCT)were detected before and 7 days after debridement in the two groups.Results The debridement time and wound healing time of the observation group were lower than those of the control group,and the survival rate of the skin was higher than that of the control group,the differences were statistically significant(P<0.05).The positive rate of bacterial culture and the rate of debridement in the observation group were lower than those in the control group(P<0.05).7 days after debridement,the serum CRP and PCT levels of the two groups were lower than those before debridement,and those in the observation group were lower than those in the control group(P<0.05).Conclusion The use of hydrodynamic debridement system to debride the residual wounds of large-area burns can effectively improve the debridement efficiency,save the operation time,be beneficial to the wound healing,improve the skin survival rate,effectively avoid bacterial infection,reduce the number of surgical debridement,and reduce the inflammation of the wound,which is worthy of promo

关 键 词：烧伤 残余创面 水动力系统 清创 修复 创面愈合 

分 类 号：R644[医药卫生—外科学]