负压创面治疗技术联合削痂植皮术在深度烧伤创面修复中的应用  

Application of Negative Pressure Wound Therapy Combined with Scab Removal and Skin Grafting in the Repair of Deep Burn Wounds

作　　者：付永峰 王嘉欣[1] 单楠 张馨元 FU Yongfeng;WANG Jiaxin;SHAN Nan;ZHANG Xinyuan(Department of Burn Plastic and Aesthetic Surgery,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China;Department of Oncology,Qinhuangdao First Hospital,Qinhuangdao 066000,Hebei,China)

机构地区：[1]秦皇岛市第一医院烧伤整形美容外科,河北秦皇岛066000 [2]秦皇岛市第一医院肿瘤科,河北秦皇岛066000

出　　处：《中国美容医学》2024年第10期89-93,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究负压创面治疗技术(Negative pressure wound therapy,NPWT)联合削痂植皮术修复深度烧伤后创面的疗效。方法:选取2020年1月-2023年1月笔者医院收治的112例深度烧伤患者,按随机数字表法分为实验组(56例)和对照组(56例)。对照组采用削痂植皮术治疗,实验组采用NPWT联合削痂植皮术进行治疗。统计比较两组患者临床疗效、创面愈合情况、疼痛评分[视觉模拟评分法(Visual analogue scale,VAS)]、外观满意度评分、炎症因子水平[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、并发症及瘢痕情况[温哥华瘢痕量表(Vancouver scar scale,VSS)]。结果:治疗后,实验组临床疗效优于对照组,创面愈合时间短于对照组,差异均有统计学意义(P<0.05);植皮术后7 d,实验组创面愈合率、皮片成活率、外观满意度评分均高于对照组(P<0.05),疼痛VAS评分、TNF-α和IL-6水平均低于对照组(P<0.05);治疗期间,实验组总并发症发生率低于对照组(P<0.05);植皮术后6个月,实验组VSS各评分及总分均低于对照组(P<0.05)。结论:NPWT联合削痂植皮术修复深度烧伤后创面疗效良好,可有效促进创面愈合,降低疼痛感,减少瘢痕形成,改善患者预后,值得临床应用。Objective To explore the repair effect of negative pressure wound therapy(NPWT)combined with scab removal and skin grafting in wound after deep burn.Methods A total of 112 patients with deep burns admitted to the author's hospital from January 2020 to January 2023 were selected and divided into experimental group(56 cases)and control group(56 cases)according to the random number table method.The control group was treated with tangential excision and skin grafting,and the experimental group was treated with NPWT combined with tangential excision and skin grafting.The clinical efficacy,wound healing,pain score[visual analogue scale(VAS)],appearance satisfaction score,inflammatory factor level[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)],complications and scar condition[Vancouver scar scale(VSS)]were compared between the two groups.Results After treatment,the clinical efficacy of the experimental group was better than that of the control group,and the wound healing time was shorter than that of the control group,and the differences were statistically significant(P<0.05).At 7 days after skin grafting,the wound healing rate,skin graft survival rate,and appearance satisfaction score of the experimental group were higher than those of the control group(P<0.05),and the pain VAS score,TNF-αand IL-6 levels were lower than those of the control group(P<0.05).During the treatment,the total incidence of complications in the experimental group was lower than that in the control group(P<0.05).At 6 months after skin grafting,the scores and total scores of VSS in the experimental group were lower than those in the control group(P<0.05).Conclusion Repair effect of NPWT combined with scab removal and skin grafting is good in wound after deep burn,which can effectively promote wound healing,relieve pain,reduce scar formation,and improve prognosis of patients,which is worthy of clinical application.

关 键 词：负压创面治疗技术 削痂 植皮 深度烧伤 创面 

分 类 号：R622[医药卫生—整形外科]