大面积烧伤患者四肢创面的整体负压封闭引流效果观察

Therapeutic efficacy of whole closed wound of limbs and acuum sealing drainage for patients with large area burns

目的:探讨大面积烧伤患者四肢创面采用整体负压封闭引流治疗的临床疗效。方法:我院2014年8月-2016年10月收治的大面积烧伤患者中,选择双侧肢体创面烧伤深度相同的患者48例,深Ⅱ度创面浅削痂,Ⅲ度创面切痂植皮,同一患者双侧肢体创面处理方法相同,然后,一侧肢体创面采取整体封闭负压引流,作为观察组,对侧肢体常规纱布包扎,作为对照组。比较48例成活患者治疗后第4、7、10、14天两组间创面愈合率及创面愈合时间。结果:观察组治疗后第7、10、14天深Ⅱ度浅削痂创面和Ⅲ度切痂植皮创面的愈合率均明显高于对照组,创面愈合时间也明显短于对照组。结论:创面在早期切削痂治疗后应用整体负压封闭引流,可促进创面愈合时间,对降低病死率有重要意义。

Objective To investigate the therapeutic effects of vacuum sealing drainage （VSD） with whole closed wound of limbs for the patients with large area burns of limbs. Methods： Of the patients with large area burns admitted to the Suzhou Hospital from Aug. 2014 to Oct. 2016, 48 cases with the same depth of wound on both sides of the same patient were involved in present study. Wounds of deep Ⅱ degree were treated by shallow paring scab, and of III degree by scab excision and skin grafting. For each patient, wounds on both sides of limbs received the same treatment, then the wounds on one side of the limb were whole closed and received VSD （observation group）, and on the other side of the limb were covered with conventional gauze （control group）. The healing rate and healing time on 4 d, 7 d, 10 d and 14 d after treatment were compared between the two groups. Results： The healing rates of the deep Ⅱ degree wounds treated by shallow paring scab and the III degree wounds treated by scab excision and skin grafting were obviously higher in observation group than in control group on 7 d, 10 d and 14 d after treatment. The healing time was also markedly shorter in observation group than in control group. Conclusions： Whole VSD for closed wound and early excision of scab are of importance in promoting the wound healing, shortening the healing time and reducing the mortality.