湿性与干燥疗法对供皮区创面治疗效果观察

Comparison of Therapeutic Effect Between Moist Therapy and Drying Therapy in Treating Donor Site Wound

目的:观察湿性半暴露疗法与传统的凡士林纱布治疗供皮区创面的疗效。方法:对我院4年内122例患者200处(整形或烧伤)手术的供皮区创面,采用同个体、同部位或同一个体的对称部位、年龄相似的病例,应用半暴露湿性疗法与半暴露干燥疗法治疗,观察其疼痛、愈合时间、感染、瘢痕增生情况。结果:湿性较干燥疗法愈合时间缩短4天～7天,创面疼痛轻微,尤其是换药时不疼痛,纱布下不积脓,不影响术后睡眠。愈后1年复诊:湿性组韧厚皮区色泽与周围皮肤无差异、薄中厚区色素沉着或脱失、中厚皮区扁平质软瘢痕,而干燥组病人剧痛需应用镇痛药、愈合时间较长、部分创面出现增生性瘢痕。结论:湿性半暴露疗法能缩短供皮区创面愈合时间,有良好的止痛和预防感染之作用,且能减少瘢痕增生,半暴露湿性疗法是供皮区创面的良好适应症。

Objective： To observe the different of clinical effect between moist semi -exposed therapy and conventional Vaseline gauze treatment in treating donor site wound. Method： 122 hospitalized patients （200 wounds） with donorsite wound were enrolled in the program last 4 years. Comparison of Semi - exposed moist therapy and semi - exposed drying therapy in the similar age patients were carried out either in the same part of the same individual, or in symmetric parts of the same individual. Indexes observed were pain degree, wound healing time, infection and scar formation. Result： The wound healing time of moist therapy was shorter than that of drying therapy. Minor wound pain, no pain when dressing changed, no empyema under gauze and good sleep of post - operation were observed in the 4 - 7 days. After one year of fol- low ~ up in moist group, there was no difference between colors of blade - thick skin and surrounding skin; pigmentation and depigmentation in thin medium split - thickness zone and flat soft scar in intermediate split - thickness zone were observed. But in drying group, the patients needed analgesics due to pain, had longer wound healing time and appeared hypertropic sear in some wound. Conclusion： Moist semi - exposed therapy is a good for indications to treat donor site wound due to shortening wound healing time, stopping pain well, preventing wound from infection and reducing scar formation.