烧伤创面细菌分布对植皮存活率的影响

Effect of the bacterial distribution on burn wound on the survival rate of grafted skin

目的 通过对烧伤病人不同时间的痂下组织细菌定量培养及种类检测 ,探讨手术时间、菌量和菌种与植皮存活率的关系。方法 选择 3 65例病人于手术时取痂下组织以组织匀浆行细菌定量并鉴定菌种。结果 45 0份标本中 3 90份为阳性 ,共培养出细菌 5 80株 ,以铜绿假单胞菌(2 7.93 %)及金黄色葡萄球菌 (16.2 0 %)为最常见种类 ;手术时间、菌量和菌种对植皮存活率均有不同程度的影响 (P <0 .0 1)。结论 手术时间越早 ,痂下组织细菌含量越少 ,菌种较单一 ,植皮存活率越高 (P <0 .0 1) ;金黄色葡萄球菌感染对植皮存活率影响较大 (P <0 .0 1)。

Objective To investigate the survival rate of grafted skin and the quantification and classification at different time points by determining subeschar tissue bacterial quantification at different postburn time points and classification of the bacteria.Methods Subeschar tissue samples were harvested from 365 burn patients by tissue homogenization with bacterial quantification and bacterial classification was made.Results Of the 450 samples,390 were positive.Five hundred and eighty strains of bacteria were cultured.The commonest strains included pseudomonas aeruginosa(27.93%) and Staphylococcus(16.20%).The survival rate of grafted skin was affected by postburn time,bacterial quantity and bacterial quantification to varying degrees(P<0.01).Conclusion The earlier the subeschar tissue bacterial quantification was done,the less the bacterial amount were with the less kinds of bacteria,the higher the survival rate of the grafted skin was(P<0.01).The major factor influencing the survival rate of the grafted skin was the infection of Staphylococcus aereus(P<0.01). [