MEBO联合ADM治愈大面积深度烧伤并发多部位骨外露1例报告

Case Report of MEBO Combined with ADM in Healing Extensive Deep Burns Complicated with Multiple Bone Exposures

目的观察湿润烧伤膏(Moist Exposed Burn Ointment,MEBO)联合猪脱细胞真皮基质(Acellular Dermis Matrix,ADM)治疗大面积深度烧伤并发多部位骨外露的临床疗效。方法对宁夏医科大学附属石嘴山市第一人民医院烧伤科收治的1例大面积烧伤并发多部位骨外露患者在抗感染、营养支持等全身综合治疗的同时,烧伤早期对深度烧伤创面进行常规切痂+自体微粒皮移植+ADM覆盖治疔;治疗3周后,见双侧髌骨、胫骨、内外踝骨及跖骨大部分骨质外露,行外露骨面电钻打孔,ADM覆盖与MEBO涂抹治疗,观察治疗效果。结果患者于入院治疗242 d后,外露骨面全部封闭,创面痊愈出院;出院后随访3个月,创面愈合良好,双下肢上抬可达75°,双膝关节屈曲可达45°,能够搀扶站立,恢复了部分肢体功能。结论 MEBO联合ADM治疗大面积深度烧伤并发多部位骨外露,创面愈合良好,能够避免截肢,且在最大程度上保留患者肢体功能,疗效显著,值得临床推广应用。

Objective To observe the clinical efficacy of Moist Exposed Burn Ointment（MEBO） combined with Acellular Dermis Matrix（ADM） in the treatment of extensive deep burns complicated with multiple bone exposures.Methods A patient with extensive burn and multiple bone exposures admitted into the burn department of Shizuishan First People＇ s Hospital Affiliated to Ningxia Medical University was given systemic comprehensive treatments including anti-infection and nutritional support.Meanwhile,escharectomy was performed on the deep burn wound at the early stage of burn,in combination with the covering of micro-skin auto-graft and ADM.3 weeks later,most bone exposures were observed on both patellas,tibia,medial and lateral malleolus and metatarsus,and hole-drilling was performed on the exposed bones combined with ADM coverage and external use of MEBO.The curative effect was observed.Results 242 days after the admission.the patient was discharged from the hospital with exposed bone closed and the wounds healed.The 3-month follow-up showed the wound healed well with both lower extremities being able to lift up to 75-degree angle and flexion of knee-joint reaching 45-degree angle.The patient could stand with assistance and limb function was partially restored.Conclusion Combination of MEBO and ADM can achieve a satisfying healing effect in the treatment of extensive deep burn with complication of multiple bone exposures.It＇ s obviously effective in protecting patients from amputation and saving limb functions maximally,deserving to be promoted in clinic.