负压封闭引流促进慢性难愈性烧伤创面愈合的效果观察

Observation on the Effect of Vacuum Sealing Drainage to Promote the Healing of Chronic Refractory Burn Wounds

目的:探究负压封闭引流(Vacuum sealing drainage,VSD)促进慢性难愈性烧伤创面愈合的效果。方法:选择2018年1月-2020年12月在徐州市第一人民医院烧伤整形科接受治疗的慢性难愈性烧伤创面患者64例的病历资料回顾性分析。全部患者根据治疗方法的差异分为对照组和观察组,两组均有32名患者。对照组采用常规创面处理方法。观察组在对照组治疗方法基础上使用VSD技术。对比两组治疗14d后的创面愈合率、创面完全愈合时间、创面完全愈合后的瘢痕评分情况(皮肤均一性评分,皮肤松弛度评分,皮肤瘢痕严重程度评分)、治疗前和治疗后1个月的血液指标(白细胞计数、血沉、血清C反应蛋白浓度)、治疗过程中的换药次数、住院时间、治疗过程中的不良反应情况。结果:两组治疗14d后的创面愈合率观察组的高于对照组的,观察组的创面愈合时间低于对照组,差异有统计学意义(P<0.05);在创面愈合后,观察组的皮肤均一性评分、皮肤松弛度评分、皮肤瘢痕严重程度评分均低于对照组,差异有统计学意义(P<0.05);治疗后1个月,观察组的白细胞计数、血沉、血清C反应蛋白浓度低于对照组,差异有统计学意义(P<0.05);观察组在治疗过程中的换药次数以及住院时间低于对照组,差异有统计学意义(P<0.05)。观察组在治疗过程中的不良反应发生率低于对照组,差异有统计学意义(P<0.05)。结论:在慢性难愈性烧伤创面患者的治疗过程中,采用VSD联合常规清创方法治疗,可提升创面的愈合效果,改善愈合后的瘢痕情况,改善创面局部的炎性反应情况,缩短创面愈合时间,降低治疗过程中的不良反应风险。

Objective To explore the effect of Vacuum sealing drainage(VSD)on promoting the healing of chronic refractory burn wounds.Methods A retrospective analysis of the medical records of 64 patients with chronic refractory burn wounds who were treated in the Burn Plastic Surgery Department of Xuzhou First People's Hospital from January 2018 to December 2020.All patients were divided into a control group and an observation group according to the difference in treatment methods.There were 32 patients in both groups.The control group used conventional wound treatment methods.The observation group used VSD technology on the basis of the treatment method of the control group.Compare the wound healing rate,the time to complete wound healing,the scar score after the wound is completely healed(skin uniformity score,skin laxity score,skin scar severity score),before treatment and 1 month after treatment in the two groups.Blood indicators(white blood cell count,erythrocyte sedimentation rate,serum C-reactive protein concentration),number of dressing changes during treatment,length of hospital stay,adverse reactions during treatment.Results The wound healing rate of the observation group was higher than that of the control group after 14 days of treatment,and the wound healing time of the observation group was lower than that of the control group(P<0.05).After wound healing,the skin uniformity score,skin laxity score,and skin scar severity score of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).One month after treatment,the white blood cell count,erythrocyte sedimentation rate,and serum C-reactive protein concentration of the observation group were lower than those of the control group(P<0.05).The number of dressing changes and the length of stay in the observation group were lower than those in the control group(P<0.05).The incidence of adverse reactions in the observation group during treatment was lower than that in the control group(P<0.05).Conclusion In the treatment of patients with chronic refractory burns,the use of VSD combined with conventional debridement methods can enhance the healing effect of the wound,improve the scar after healing,improve the local infl ammatory reaction of the wound,and shorten the wound healing time,reduce the risk of adverse reactions during treatment.