早期应用负压封闭引流技术治疗深Ⅱ度手烧伤  

Treatment of deep second degree hand burn by early application of vacuum sealing drainage

作　　者：刘灿滨 郑建军 刘维 郑林文 许钊荣 陈昭宏 陈舜 LIU Canbin;ZHENG Jianjun;LIU Wei(Department Burn Wound Repair,Fujian Medical University Union Hospital,Fujian Burn Institute,Fujian Burn Medical Center,Fujian Provincial Key Laboratory of Burn and Trauma,Fuzhou,Fujian,350001,China)

机构地区：[1]福建医科大学附属协和医院福建省烧伤研究所福建省烧伤医学中心福建省烧创伤重点实验室烧伤与创面修复科,福建福州350001

出　　处：《实用手外科杂志》2022年第3期296-298,382,共4页Journal of Practical Hand Surgery

基　　金：此研究成果由福建省医疗“创双高”建设经费、福建省烧创伤重点实验室资助(项目编号:闽卫医政[2021]76号)。

摘　　要：目的评价早期应用负压封闭引流技术(Vacuum sealing drainage,VSD)治疗深Ⅱ度手烧伤创面的临床疗效。方法对2016年4月-2018年3月收治的深Ⅱ度手烧伤患者20例,伤后早期清创,负压材料覆盖后持续封闭引流,每周更换负压材料同时评估创面,根据创基情况决定是否继续负压治疗或手术植皮。观察创面愈合时间及愈合后手功能恢复情况。结果20例共20个创面平均愈合时间(22.6±7.3)d,第一次VSD技术治疗时间为伤后(2.9±2.6)d,第二次VSD技术治疗时间为伤后(10.0±2.3)d,第三次VSD技术治疗时间为伤后(16.0±1.2)d。15例VSD技术治疗后痊愈,5例VSD技术联合植皮手术痊愈。随访6个月,手部瘢痕形成少,手功能恢复优良率60%,合格率95%,功能恢复满意。结论早期应用负压封闭引流技术治疗深Ⅱ度手烧伤创面能缩短愈合时间、减轻瘢痕增生,手功能恢复良好,值得临床应用及推广。Objective To evaluate the clinical effect of the early application of vacuum sealing drainage(VSD)in the treatment of deep second degree hand burn.Methods Twenty cases of deep second degree hand burn were collected in our department between April 2016 and March 2018,and 0.5%~3%TBSA of hand burn wound.VSD therapy was applicated after early-stage debridement and changed every week.The burn wound was evaluated while VSD chaging,to decide whether skin graft or further VSD therapy was needed.The wound healing time and hand function after healing were observed.Results Twenty hand burn wounds of 20 patients were collected,and the wound healing time was(22.6±7.3)days.The application of VSD for the first time was(2.9±2.6)days after burn,while(10.0±2.3)days and(16.0±1.2)days for the second and third time respectively.15 patients were cured after VSD therapy,meanwhile 5 patients were cured after VSD therapy and skin graft.All patients were followed up 6 months,with less scar formation and satisfied hand function.According to the result of hand function evaluation,the excellent and good rate was 60%.Conclusion Early application of VSD in the treatment of deep second degree hand burn can shorten the healing time,with the result of less scar formation and satisfied hand function,warranting further research for clinical applications.

关 键 词：手烧伤 负压封闭引流 植皮术 功能康复 

分 类 号：R644[医药卫生—外科学]