磨痂术治疗深Ⅱ度烧伤疗效观察

Therapeutic Observation of Dermabrasion Treatment in Deep Ⅱ Degree Burn

目的 观察磨痂术治疗深Ⅱ度烧伤的临床疗效。方法 2010年1月～ 2013年6月期间,观察作者单位150例烧伤患者,性别不限,年龄5 ～ 60岁,平均年龄39岁,烧伤总面积10％ ～ 85％。其中,85例双手背深Ⅱ度烧伤患者采取一侧手背磨痂、另一侧手背削痂,磨、削痂后移植自体薄中厚皮片。65例非功能部位深Ⅱ度烧伤患者,每例分成3组,磨痂生物敷料组：创面磨痂后覆盖异种脱细胞猪皮;磨痂银离子敷料组：创面磨痂后用银离子烧烫伤敷料换药治疗;保守换药组：不手术,用银离子烧烫伤敷料换药。结果 手背磨痂植皮组皮片成活率及外形功能优良率高于手背削痂植皮组（P＜0.05）;非功能部位磨痂生物敷料组平均愈合时间为16天,少于磨痂银离子敷料组20天（P＜0.05）,明显少于保守换药组26天（P＜0.01）;非功能部位磨痂生物敷料组瘢痕增生率低于磨痂后覆盖银离子敷料组（P＜0.05）,明显低于保守换药组的瘢痕增生率（P＜0.01）。结论 手背深Ⅱ度烧伤磨痂后移植自体薄中厚皮片,皮片成活率高,外形及功能满意;非功能部位深Ⅱ度烧伤磨痂后覆盖异种脱细胞猪皮,愈合时间短、瘢痕少、疗效可靠;磨痂术治疗深Ⅱ度烧伤的治疗方法技术成熟、容易操作、疗效可靠,有应用推广价值。

Objective To evaluate the clinical efficacy of dermabrasion treatment of deep Ⅱ degree burn.Methods From January 2010 to June 2013,150 burn patients were observed in Author＇s hospital,male or female,aged 5 to 60 years,mean age 39 years.Total burn area of 10 to 85％.Among them,85 cases with both hands back deep Ⅱ degree bum,one side treated with dermabrasion,the other side cut the crust,grind and implanted with autologous thin medium thickness slices.For 65 cases with non-functional area of the deep Ⅱ degree burn,patients were divided into three groups：dermabrasion biological dressing group：dermabrasion wounds covered with xenogenesis acellular pigskin; dermabrasion silver ion dressing group：dermabrasion burn wounds treated with silver ions dressing; conservative dressing group：no surgery,change dressing with silver ions dressing.Results Hand-back dermabrasion skin graft survival rate and graft function excellence rate was higher than hand-back of tangential excision group （P ＜ O.05）.For non-functional parts of the dermabrasion biological dressing group,the average healing time was 16 days,less than dermabrasion silver ion dressing group of 20 days （P ＜ 0.05）,significantly less than the conservative dressing group of 26 days （P ＜ 0.01）.For non-functional area of the dermabrasion biological dressing group,scarring after dermabrasion coverage rate was lower than the silver ion dressing group （P ＜ 0.05）,significantly lower than the scarring rate （P ＜ 0.01） of conservative dressing group.Conclusion With hand-back deep Ⅱ degree bums post dermabrasion autologous thin medium thickness skin graft treatment,skin graft survival rate is high,the shape and function is satisfied.For non-functional area deep Ⅱ degree bums covered by dermabrasion acellular pigskin,healing time is short,with less scarring,and reliable effectiveness.Dermabrasion treatment of deep Ⅱ degree burn with mature technology,is easy to operate,reliable and effective and has application value.