MEBT/MEBO治疗足部Ⅲ度烧伤临床疗效分析

Clinical Therapeutic Effect Analysis of Treating Foot Third-degree Burns with MEBT/MEBO

目的总结烧伤湿性医疗技术（MEBT／MEBO）在足部Ⅲ度烧伤治疗中的特点及愈合后的远、近期效果。方法对22例足部Ⅲ度烧伤患者全程采用MEBT／MEBO治疗，于烧伤后24h内对创面行皮肤耕耘减张术处理，并取创面组织做病理检查，明确烧伤深度。皮肤耕耘减张处理后，创面外用湿润烧伤膏（MEBO）换药治疗，每6h换药1次，液化期间，适当增加换药次数。对新愈合上皮组织进行活检，证实皮肤原位再生；伤后60d．对不能自愈的创面。在清除坏死组织、培养肉芽组织后行植皮手术治疗。结果22例患者全部治愈出院，其中植皮者4例，所有患者均未行二次整形手术，创面平均愈合时间为50．18d±16．39d，出院后随访1～10年，有8例出现轻度瘢痕增生，愈合效果满意。结论MEBT／MEBO有利于足部深度烧伤创面皮肤再生，减少致残率，最大限度地维持患肢的外观，值得临床推广应用。

Objective To summarize the characteristics of MEBT/MEBO in the treatment of foot third-degree bums and its short-term and long-term effects after wound healing. Methods Twenty-two patients with foot third-degree burns were treated with MEBT/MEBO throughout the whole period of treatment. Within 24 hours postburn, the wounds were managed with skin incision and tension relieving technique and the wound tissues were taken for pathological examination to confirm the bum depth. After that, MEBO was topically used to manage the wound and the dressing was changed every six hours. During the liquefaction stage, the frequency of dressing change was increased accordingly. Biopsy on the newly- healed epithelial tissues was performed to confirm skin regeneration in situ. On day 60 postburn, for the wounds remaining unhealed, skin grafting was performed after the removal of necrotic tissues and the cultivation of granulation tissues were completed. Results All 22 patients were cured and discharged, of whom 4 patients were performed skin grafting. No pa- tient was given secondary plastic surgery. The average wound healing time was 50. 18 d -＋ 16. 39 d. During the follow-up of 1 - 10 years after discharge, 8 patients deve/oped mild scar hyperplasia, and the healing effects were satisfying. Conclusion MEBT/EMBO is worth of promotion and application in clinic in that it facilitates the skin regeneration of foot deep bum, re- duces the disability rate and maintains the appearance of the affected limbs maximally intact.