功能部位深度烧伤的综合康复治疗320例临床观察

Comprehensive rehabilitation in deep burn injury of position of function

目的探讨早期综合康复治疗对功能部位深度烧伤愈后瘢痕增生及挛缩畸形的防治作用。方法 2004～2010年功能部位深Ⅱ度以上烧伤患者,采取早期切削痂中厚皮移植,术后固定于伸直或功能位。7～10d渐开始康复功能训练,拆线后即行硅胶膜贴敷及弹力套加压治疗和康复功能锻炼。结果 320例患者共计758个功能部位用该方法获得了满意的治疗效果,功能及外形良好者达90%以上。结论功能部位深度烧伤在伤后3～5d内行切削痂植皮手术,术后正确的固定和早期进行功能锻炼以及瘢痕增生的综合防治是保证各关节功能部位恢复良好的关键,综合康复措施应贯穿治疗的全过程。

Objective To prevent the proliferation of scar deformity contracture in position of function after deep burn injury and restore every position good function.Methods 758positions（320 cases） with deep second degree burn over during 2004 to 2010 were enrolled in this study.The escharectomy and skin grafting were performed between two and five days after burn injury.Early functional exercise was done and elastic glove and silicone gel sheeting were used to compress the grafting.Results The satisfactory effects were obtained in more than 90%of cases the function and outline were excellent.Conclusion The best time of early escharectomy is within five days after burn.Treating position of function depth burns with early escharectomy and skin grafting not only prevent the joint position from deformation and restore the joint function but also shorten the period of treatment and alleviate the suffering and expensive burden for the patients.Comprehensive rehabilitation measures should run through the whole process of treatment.