烧伤湿润暴露疗法治疗大面积烧伤病人的护理

NURSING EXPERIENCE IN TREATING LARGE AREA BURN PATIENTS WITH MOIST EXPOSED THERAPY

湿润烧伤膏(以下简称MEBO)和烧伤湿润暴露疗法是近年来治疗烧伤病人的新方法。今年5月我科对客车内火药燃爆事故的10例大面积烧伤病人的创面,按烧伤湿润暴露疗法理论用MEBO上药,效果好。现谈谈湿润烧伤膏和烧伤湿润暴露疗法治疗大面积烧伤病人的护理体会。

In last May, our hospital treated 10 patients with large area burn due to gun powder explosion in passenger train, using moist exposed therapy. All the patients healed. I . Clinical Data: 5 males and 1 female, age range 19 to 48, 4 cases with total burn area 30-39%of body surface, 4 cases 40-59% and 2 cases 60-82%, 7 cases complicated with respiratory tract burn, superficial 2nd degree 28% deep 2nd .degree 52%and superficial 3rd degree 20%. II. Nursing: 1. Immediate treatment after hospitalization included alloting of the wards in an orderly way, establishing of special nursing group, carrying out skin test, infusion, blood sample drawing, ill con- dition observing, intake and output volume re-cording, vein incision if needed and keeping ade-quate drainage. 2. Treating the wound surface: Debridement was done after hospitalization and MEBO was applied. The wound was kept exposed. At the ear-ly stage ( in a week ) the exudate was increasing and the loss of the ointment was very quick. Application of MEBO every 3 or 5 hours was necessary. Gauze prepared by immersion in MEBO should be applied to wounds under pressure. Patients were urged to turn over regularly. For deep wounds, the smearing of the ointment should be thicker and timely clearing of the exudate was needed and necrotic tissue timely excised. 3. Nutrition supply: In addition to intravenous infusion, oral feeding of liquid diets or ordinary diets with high protein, high calorie and high vit-amin was needed to ensure 3500 calorie and 100 grams of protein every day. 4. Psychological nursing: Help the patients to dispel misgivings and to cooperate with the treatment by doing aimed odeological work. 5. Early function training: It is helpful to the recovery of the functioning of the joints. Ⅲ. Efficacy: 10 patients all healed. Patients with 3rd degree burn had scars but no contracture and the others had the extension-flexion function of their upper limbs well recovered. IV. Experience: 1. good analgesic effect, 2. quick healing of the wound, 3. simple procedure and easy to learn, 4. no' need of special facilities, 5. prevention of infections is very important during scab dissolving period.