MEBO治疗22例中、重度烧伤创面的临床体会

CLINICAL EXPERIENCE IN TREATING MODERATELY SEVERE BURN WOUNDS USING MEBO

作者自1988年6月至1991年5月应用MEBO治疗大面积烧伤病人26例,其中中、重度创面行切削坏死组织后涂MEBO的22例,均获得疤痕轻,功能正常的满意疗效。本组病例最大面积95％,最小面积50％,Ⅲ度创面最大面积40％,最小面积10％。在创面处理中提出了5～9天后应用滚轴刀或手术刀切削坏死组织层(为坏死层的2/3或4/5,以不痛、不出血、不损伤间生态组织为原则。切削痂后厚涂MEBO包扎,24小时换药一次,换药时尽量清除已松动软化的坏死组织,清创过程尽量在伤后15～20天内完成。待肉芽新鲜时,视皮岛多少,再决定植皮或等待自行愈合,争取35～45天封闭创面。

The authors used MEBO for treating 26 cases of large area burn in the period from June, 1988 to May, 1991. Among them 22 cases had moder-ate and severe and third degree burns. MEBO was applied after excision of the necrotic tissue. All the patients healed with satisfactory restoration of the function and only very slight scar formation. The largest burn area was 95%BSA and the amallest 50%BSA. The largest area of third degree burn was 40%BSA and the smallest 10%BSA. The necrotic tissue (2 / 3 or 4 / 5 of the necrotic layer) was excised using a rolling knife or a lancet. 5 to 9 days post burn. No pain, no bleeding and no damage in the ecological organization are the es-sential requirements during the operation. After excision, MEBO was smeared on the wounds to an adequate thickness and the wounds were ban- daged. The change of dressings was performed once every 24 hours. Soft and loose tissues were cleared away. The debriedement was finished 1 5 to 20 days post burn. After granulation, whether the wounds were to be skin grafted or were to the left to heal spontaneously, depended on the num-ber of the skin islands. The wounds were ex-pected to close in 35 to 45 days postburn.