MEBO与微粒皮种植术治疗Ⅳ度压疮的临床体会

Clinical Experience of Treating the Ⅳ Degree Pressure Sore with MEBO Plus Micro-skin Grafting

目的:回顾性总结应用MEBO结合自体微粒皮种植术治疗Ⅳ度压疮的临床效果,探讨其临床应用价值。方法:自2006年7月～2009年10月间,我科共收治16例31处Ⅳ度压疮患者,创面应用MEBO治疗,用无菌手术刀切除变性坏死的组织,待肉芽组织新鲜后施行微粒皮种植术,再用MEBO换药至创面修复。结果:11例24处Ⅳ度压疮溃疡面应用MEBO治疗后肉芽组织新鲜,施行微粒皮种植术后创面封闭;3例4处创面应用MEBO后溃疡面修复未植皮;1例2处施行微粒皮种植术后1周,创面新鲜皮片成活好,自动要求出院;1例住院25天坏死组织已去除,创面肉芽新鲜,创周上皮生长良好,因经济原因自动出院。结论:MEBO与自体微粒皮种植术结合治疗Ⅳ度压疮,溃疡面积明显缩小,修复后的皮肤柔软,修复的创面基本与正常皮肤面平行、瘢痕少,患者痛苦小,费用低。

Objective： To retrospectively summarize that the application of the MEBO plus autologous micro- skin grafting to treat Ⅳ degree pressure sores so as to discuss its clinical value. Methods： During the period of 7/2006 - 10/ 2009, 16 patients with IV degree pressure sores （31 wounds） were treated with MEBO. Firstly, removed degeneration and necrosis tissue with sterile scalpel, then, micro - skin grafting was conducted after fresh granulation tissue appeared. Finaly, MEBO ointment was applied as dressing change up to wound repaired. Results： All of 16 cases, the wounds of 11 cases （24 wounds） were closed after micro - skin grafting and the tissues of granulation were kept in fresh after MEBO applied. 3 cases （4 wounds） healed directly after MEBO applied without skin grafting. One ease （2 wounds） discharged under patient＇ s requirement after one week of micro- skin grafting, at the time the fresh skin split survived well Another one case discharged after hospitalized for 25d because of economic reasons, though necrosis tissue removed, fresh granulation tissue appeared, and epidermises around the sore surface grown well. Conclusion： MEBO plus micro - skin grafting treat IV pressure sores has some advantages including obviously reducing ulcer area, soft repaired skin available, little scar formation, less pain and low- cost.