床旁分次刮痂在小面积深Ⅱ°烧伤创面的应用

The Application of Bedside Scraping Scab by Several Times in Small Area Deep Ⅱ° Burn Wounds

目的探讨床旁分次刮痂对小面积深Ⅱ°烧伤患者的临床疗效。方法选取我科2012年1月至2014年10月收治的双上肢或双下肢相对应部位小面积深Ⅱ°烧伤患者56例为研究对象,按坏死组织清除方式不同将相对应肢体随机分为A组和B组。A组在常规换药的同时加用分次刮除创面坏死组织的方法进行治疗,B组采用常规换药的方法进行治疗。对两组创面的愈合时间及愈合后瘢痕形成情况进行比较。结果 A组创面平均愈合时间为(19.2±1.5)d,显著短于B组的(20.2±2.2)d,差异具有统计学意义(t=2.8104,P<0.05)。愈合后三个月回访,部分经较长时间愈合创面(创面愈合时间超过20天)均有不同程度瘢痕形成。两组创面面积比较差异无统计学意义(P>0.05),且两组均有少部分创面感染。结论床旁分次刮痂治疗小面积深Ⅱ°烧伤可加速烧伤创面愈合。

Objective To investigate the clinical effect of bedside scraping scab by several times in patients with small area deepⅡ°burn wounds. Methods 56 cases of patients with small area deep Ⅱ°burn wounds at the corresponding parts of double upper limbs and lower limbs admitted to our department from January 2012 to October 2014 were selected as research objects. The corresponding limbs were divided into group A and group B according to the different methods of removing necrotic tissue. Group A was given bedside scraping scab by several times on the basis of conventional dressing change, group B was treated with conventional dressing change. The healing time of the wound and scar formation after healing of two groups were compared. Results The average healing time of wound in group A was（19.2 ± 1.5） d, significantly shorter than（20.2 ± 2.2） d in group B, the difference was statistically significant（t = 2.8104, P〈0.05）. All patients were followed up after three months of concrescence, and the results showed that wounds after a long time（more than 20 days） to heal had different degrees of scar. The wound area of two groups had no statistical difference（P〉0.05）, and both groups had a small portion of wound infection. Conclusions Bedside scraping scab by several times can obviously accelerate the wound healing in treating small area deep Ⅱ°burn wounds.