扩创植皮联合封闭负压引流技术在大面积烧伤患者感染难愈创面治疗的效果

Effect of debridement skin grafting combined with vacuum sealing drainage on treatment of large-area burns patients with refractory wound infection

目的探讨扩创植皮联合封闭负压引流技术在大面积烧伤患者感染难愈创面治疗的效果,为临床治疗提供依据。方法选取2011年6月-2016年6月医院收治的大面积烧伤感染难愈创面患者62例,根据收治时间不同将患者分为观察者与对照组,各31例,给予对照组扩创植皮治疗,观察组给予扩创植皮治疗基础上联合封闭负压引流治疗,对两组治疗总有效率、植皮成活率、创面愈合率及并发症发生率等进行比较。结果观察组与对照组治疗总有效率分别为90.3%、67.7%,观察组与对照组相比其治疗总有效率明显提高,差异有统计学意义(P<0.05);观察组与对照组术后第3天植皮成活率分别为80.6%、38.7%,两组间比较差异有统计学意义(P<0.05);观察组与对照组患者术后第6天创面愈合率分别为87.1%、35.5%,两组间比较差异有统计学意义(P<0.05);观察组平均住院时间为(37.9±7.5)d,对照组平均住院时间为(45.7±14.3)d,观察组与对照组相比明显缩短,差异有统计学意义(P<0.05);与对照组比较,观察组术后前三次换药时的VAS疼痛评分均明显降低,差异有统计学意义(P<0.05);在并发症发生率方面,观察组3.2%与对照组16.1%比较明显降低,差异有统计学意义(P<0.05);在治疗满意度方面,观察组治疗总满意度为93.5%,与对照组治疗总满意度74.2%相比明显升高,差异有统计学意义(P<0.05)。结论对大面积烧伤感染难愈创面患者给予扩创植皮联合封闭负压引流治疗具有良好的治疗效果,可提高植皮成功率及创面愈合率,并降低并发症发生率,值得临床进一步推广应用。

OBJECTIVE To explore the effect of debridement skin grafting combined with vacuum sealing drainage on treatment of large-area burns patients with refractory wound infection so as to provide guidance for clinical treatment.METHODS A total of 62large-area burns patients with refractory wound infection who were treated in hospitals from Jun 2016 to Jun 2016 were enrolled in the study and divided into the observation group and the control group according to the treatment time,with 31 cases in each group.The control group was treated with debridement skin grafting,while the observation group was given debridement skin grafting combined with vacuum sealing drainage.The total effective rate of treatment,survival rate of skin graft,rate of wound healing,and incidence of complications were observed and compared between the two groups of patients.RESULTS The total effective rate of treatment of the observation group was 90.3%,significantly higher than 67.7% of the control group（P〈0.05）.The survival rate of skin graft was 80.6% in the observation group after the surgery for 3days,38.7%in the control group,and there was significant difference between the two groups（P〈0.05）.The rate of wound healing was 87.1%in the observation group after the surgery for 6days,35.5%in the control group,and there was significant difference between the two groups（P〈0.05）.The mean hospitalization duration of the observation group was（37.9±7.5）days,significantly shorter than（45.7±14.3）days of the control group（P〈0.05）.The VAS pain scores of the observation group were significantly lower than those of the control group at the fist three dressings after the surgery（P〈0.05）.The incidence of complications of the observation group was3.2%,significantly lower than 16.1% of the control group（P〈0.05）.The total satisfaction with treatment was93.5%in the observation group,significantly higher than 74.2%in the control group（P〈0.05）.CONCLUSION The debridement skin grafting combined with vacuum sealing drainage can achieve significant therapeutic effect on the large-area burns patients with refractory wound infection,raise the success rate of skin grafting and rate of wound healing,and reduce the incidence of complication;it is worthy to be further promoted in the hospital.