新型削痂刀在深Ⅱ度烧伤创面早期治疗中的应用效果观察  

Application of a novel eschar cutter in early treatment of deep second degree burn wounds

作　　者：王振君[1] 彭丽丽 潘孙峰[1] 方高丰[1] 朱敏达 马祯一 WANG Zhenjun;PENG Lili;PAN Sunfeng;FANG Gaofeng;ZHU Minda;MA Zhenyi(不详;Department of Burn and Plastic Surgery,Jiaxing Traditional Chinese Medicine Hospital,Jiaxing 314001,China)

机构地区：[1]嘉兴市中医医院烧伤整形科,314001 [2]嘉兴市中医医院病理科,314001

出　　处：《浙江医学》2022年第2期154-157,I0003,I0004,共6页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2020PY075);嘉兴市科技计划项目(2019AY32017)。

摘　　要：目的观察自行研制的新型削痂刀在深Ⅱ度烧伤创面早期(烧伤48 h内)治疗中的临床效果。方法选取2019年6月至2020年8月嘉兴市中医医院烧伤整形科收治的深Ⅱ度烧伤患者30例,均行早期削痂治疗。每例患者创面依照部位对称、深度相同、面积相近的同体配对对照原则,分为观察侧和对照侧。观察侧应用新型削痂刀进行创面削痂手术处理,对照侧应用滚轴取皮刀传统削痂处理创面。观察并比较两组创面出血量、手术时间、愈合时间、术后3个月瘢痕增生情况[采用改良温哥华瘢痕评估量表(mVSS)评分、创面瘢痕瘙痒评分法评估],分析其临床疗效。结果与对照侧创面比较,观察侧创面出血量较少[(5.13±1.02)层渗血纱布比(12.23±4.72)层渗血纱布]、手术时间较短[(27.86±8.16)min比(40.33±10.74)min]、愈合较快[(18.06±3.23)d比(22.17±4.83)d],差异均有统计学意义(均P<0.05)。术后3个月,观察侧创面mVSS评分低于对照侧[(2.50±0.74)分比(4.27±1.21)分,P<0.05],创面瘢痕瘙痒评分亦低于对照侧[(2.60±0.89)分比(4.50±1.69)分,P<0.05]。结论采用新型削痂刀治疗早期深Ⅱ度烧伤创面可减少术中出血、缩短手术时间、加快创面愈合进程,并可减轻瘢痕增生程度,值得临床推广应用。Objective To evaluate the application of a novel eschar cutter in the early treatment of deep second degree burn wounds.Methods From June 2019 to August 2020,30 patients with deep second degree burns were treated with early escharectomy in Department of Burn and Plastic Surgery,Jiaxing Hospital of Traditional Chinese Medicine.The wounds were divided into study side and control side in each patient,according to the principle of symmetrical parts,same depth and similar area.The scab of the wound surface in study group was cut by using the novel eschar cutter,while the conventional eschar cutter was used in control group.The amount of wound bleeding,operation time,wound healing time and scar hyperplasia in 3 months after operation(as evaluated by Vancouver scar scale score and scar pruritus degree score)were observed and compared between the two groups.Results Compared with control group,the wound in the study group had less bleeding[(5.13±1.02)layer bleeding gauze vs.(12.23±4.72)layer bleeding gauze,P<0.05],shorter operation time[(27.86±8.16)min vs.(40.33±10.74)min,P<0.05]and faster healing[(18.06±3.23)d vs.(22.17±4.83)d,P<0.05].Three months after operation,the mVSS score of the wound in the study group was lower than that of the control group[(2.50±0.74)score vs.(4.27±1.21)score,P<0.05],and the wound scar pruritus score was also lower than that of the control side group[(2.60±0.89)score vs.(4.50±1.69)score,P<0.05].Conclusion Using the novel eschar cutter to treat early deep second degree burn wounds can reduce intraoperative bleeding,shorten operation time,accelerate wound healing process,and reduce scar hyperplasia,which is worthy of clinical application.

关 键 词：深Ⅱ度烧伤创面 烧伤早期 新型削痂刀 瘢痕 

分 类 号：R644[医药卫生—外科学]