壳聚糖抗菌生物医用膜在烧伤创面中的临床应用

The clinical application of chitosan antimicrobial biomedical membrane on burn wounds

目的总结水溶性壳聚糖抗菌生物医用膜凝胶剂(商品名:凯舒林)对人体II度烧伤创面的治疗作用和安全性,并探索后期创面色素沉着、瘢痕增殖的机制。方法选择II度烧伤患者60例,用药前均用生理盐水清洁创面、去腐皮,于创面上均匀涂壳聚糖抗菌生物医用膜治疗,观察记录创面成痂、止痛、感染及痂下愈合时间,追踪随访6个月后创面色素沉着及瘢痕增殖程度。结果本组60例使用壳聚糖抗菌生物医用膜治疗的烧伤患者,创面全部自行愈合。治愈时间:浅Ⅱ度患者平均8.5 d;深Ⅱ度患者平均19 d。创面愈合后随访6个月,浅Ⅱ度创面患者3个月内有轻度色素改变,3个月后逐步恢复正常;深Ⅱ度创面患者3个月后部分患者有散在的点样色素脱失改变;部分患者有散在的扁平瘢痕。随访6个月,创面色素沉着和瘢痕增生程度明显减轻,功能明显改善,未见瘢痕疙瘩增殖。结论壳聚糖抗菌生物医用膜用于烧伤创面具有良好的组织相容性,止痛效果好,创面成痂快,兼有控制创面感染,促进愈合,减轻瘢痕增殖的作用,无明显不良反应,安全性好。

Objective To observe the water-soluble chitosan antimicrobial biomedical membrane（Trade name： Kai Shulin） to human body II degree burn wounds treatment effect and safety,and explore the mechanism of wound pigmentation,scar proliferation.Methods Choose 60 patients with II degree burns were evenly coated with chitosan antibacterial biomedical membrane treatment,observed and recorded wound scab,pain,infection and the healing time,followed up 6 months after the wound and scar pigmentation degree of proliferation.Results 60 patients using chitosan antibacterial biological medical to treat burn,wound healing all on its own.Cure time： shallow Ⅱ degrees average is 8.5 d;Deep Ⅱ degree average is 19 d.Follow-up of 6 months after the wound healing,shallow Ⅱ degree wound patient have mild pigment change in three months,3 months later gradually returned to normal;Deep Ⅱ degree with wounds in some patients have scattered sample point disfiguring changes 13 months later;Some patients have scattered flat scar.Follow-up of 6 months,wound pigmentation and significantly reduce scar tissue hyperplasia,function obviously improved,did not see the proliferation of scar a knot in one＇s heart.Conclusion Chitosan antimicrobial biomedical membranes used for burn wound treatment has the advantages of good biocompatibility,no allergic reactions,both pain relief,control wound infection,promote healing and reduce scar proliferation.