大面积烧伤混合度创面三种治疗方法结果回顾性分析

The retrospective analysis of three methods for treating mixed-depth burn wounds in extensively burned patients

目的 :探讨大面积烧伤深Ⅱ度与Ⅲ度相间混合度创面三种治疗方法的疗效和特点。方法 :1989年 1月至 2 0 0 1年 9月应用切痂微粒皮移植、保痂扩创植皮、削痂微粒皮移植三种治疗方法 ,处理 6 4例大面积烧伤混合度创面并对治疗结果进行回顾性分析。结果 :创面平均愈合时间 :削痂微粒皮移植组 42 5± 6 3天 ,切痂微粒皮移植组 5 0 4± 8 2天 ,保痂扩创植皮组 5 3 6± 7 6天。削痂组创面上皮化快 ,并发症少 ,疤痕增生轻 ;切痂组手术打击大 ,愈后外形差 ,并丧失了皮肤附属器 ;保痂组病程长 ,消耗大 ,脓毒症等并发症发生率高。结论 :伤后及时清除坏死组织并有效的覆盖创面 ,对加快创面愈合 ,缩短病程 ,减少创面侵袭性感染和各脏器功能损害非常重要。削痂微粒皮移植治疗大面积烧伤深Ⅱ度与Ⅲ度相间混合度创面 ,可保留皮肤组织的部分功能 ,抑制疤痕增生 。

Objective:To have a comparative study of three methods for treating mixed-depth wounds in extensively burned patients.Methods:The results of three operating methods were analyzed retrospectively in 64 cases between January 1989 and september 2001 with escharectomy micro-skin-grafting in 26 cases?tangential excision micro-skin-grafting in 22 cases and conservative means in 16 cases.Results:The average healing time ind tangential-excision group was 42.5±6.3 days while escharectomy group 50.4±8.2 days and conservative group 53.6±7.6 days.The patients in tangential-excision group had good cosmetic results and less scar formation.The patients with escharectomy had unsatisfactory appearances and the sweat and sebaceous glands were badly impaired.The patients in conservative group had longer hospitalization and sustained more complications.Conclusion:Tangential excision with microskin-grafting for treating mixed-depth burn wounds could effectively cover the wounds,reduced the length of hospitalization.The patients could have good cosmetic results and less contour deformity.