磺胺嘧啶银脂质水凝胶敷料联合负压吸引装置应用于肢体深Ⅱ度烧伤削痂术后创面的疗效  

Application of silver sulfadiazine hydrogel dressing combined with negative pressure device on wound surface after escharectomy for deep second degree burn of limbs

作　　者：王智忠[1] 刘利华[1] 努尔兰[1] 查天建[1] 焦静龙 苏福增[1] 刘小龙[1] WANG Zhizhong;LIU Lihua;NU Erlan;ZHA Tianjian;JIAO Jinglong;SU Fuzeng;LIU Xiaolong(Department of Burn Repair Surgery,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,Xinjiang,China)

机构地区：[1]新疆维吾尔自治区人民医院烧伤创面修复外科,新疆乌鲁木齐830001

出　　处：《上海医学》2021年第12期930-933,共4页Shanghai Medical Journal

摘　　要：目的探讨磺胺嘧啶银脂质水凝胶(SSD)敷料联合负压吸引装置应用于肢体深Ⅱ度烧伤削痂术后创面的疗效。方法选择2018年4月—2019年5月在新疆维吾尔自治区人民医院烧伤创面修复外科行削痂术的肢体深Ⅱ度烧伤患者92例,其中男61例、女31例;随机分为干预组和对照组,每组46例。干预组于削痂术后应用负压吸引装置下贴附单层SSD敷料处理创面,对照组于削痂术后应用单层油纱布联合负压吸引装置处理创面。比较两组患者的创面愈合时间、术后2周创面愈合率、创面愈合后的瘢痕高度和瘢痕面积,以及换药总次数、换药总费用。结果干预组患者创面愈合时间为(19.02±2.04)d,显著短于对照组的(26.15±1.35)d(t=-19.78,P<0.05);干预组术后2周创面愈合率为(78.72±6.09)%,显著高于对照组的(61.26±5.57)%(t=14.342,P<0.05)。干预组创面愈合后的瘢痕高度、瘢痕面积分别为(0.64±0.26)cm、(2.65±0.80)%,均显著小于对照组的(1.10±0.28)cm、(3.93±0.61)%(t值分别为-8.26、-8.68,P值均<0.05)。干预组创面愈合后的换药总次数为(3.02±0.61)次,显著少于对照组的(5.24±0.94)次(t=-13.32,P<0.05)。干预组、对照组换药总费用分别为(9752.79±611.08)、(9722.13±592.03)元,两组间的差异无统计学意义(t=0.238,P>0.05)。结论单层SSD敷料联合负压吸引装置可使创面渗出"零聚积",从而控制创面继发感染,刺激创面毛细血管生长,加快肉芽组织生长,促进创面愈合。Objective To investigate the effect of silver sulfadiazine hydrogel dressing(SSD)combined with negative pressure device on the wound surface after eschar ablation for deep second-degree burn of limbs.Methods A total of 92 patients(61 males and 31 females)with deep second-degree burn of limbs who underwent escharectomy from April 2018 to May 2019 in the People’s Hospital of Xinjiang Uygur Autonomous Region were randomly divided into intervention group and control group(n=46).After escharectomy,the intervention group was treated with SSD and negative pressure device,and the control group was treated with single-layer oil gauze and negative pressure device.The wound healing time,wound healing rate,scar height,scar area,dressing change times and cost were compared between the two groups.Results The time of wound healing in the intervention group was significantly shorter than that in the control group([19.02±2.04]d vs.[26.15±1.35]d,t=-19.78,P<0.05).The rate of wound healing with 2 weeks after escharectomy in the intervention group was significantly higher than that in the control group([78.72±6.09]%vs.[61.26±5.57]%,t=14.342,P<0.05).The scar height and scar area were(0.64±0.26)cm and(2.65±0.80)%in the intervention group,respectively,which were significantly smaller than those in the control group([1.10±0.28]cm,[3.93±0.61]%,t=-8.26 and-8.68,both P<0.05).The total times of dressing change in the intervention group were significantly less than that in the control group(3.02±0.61 vs.5.24±0.94,t=-13.32,P<0.05).There was no significant difference in the total cost of dressing change between the two groups(intervention group vs.control group:[9752.79±611.08]yuan vs.[9722.13±592.03]yuan,t=0.238,P>0.05).Conclusion A single-layer SSD under negative pressure device can control secondary wound infection by“zero accumulation”wound exudation,and accelerate wound healing by stimulating wound capillary growth and expediting the formation of granulation tissue.

关 键 词：磺胺嘧啶银脂质水凝胶敷料 负压吸引装置 深Ⅱ度创面 削痂术 

分 类 号：R644[医药卫生—外科学]