NPWT在儿童深度烧伤创面植皮术后的应用研究

Application of NPWT in Skin Grafting After Deep Burn Wounds in Children

目的比较儿童深度烧伤创面植皮术后应用负压封闭引流技术(negative pressure wound therapy,NPWT)与传统打包加压固定的临床应用效果。方法回顾性分析2014年6月至2017年6月四川省医学科学院·四川省人民医院烧伤科收治的60例儿童深度烧伤并施行植皮手术修复的临床资料,根据植皮术后固定材料及方式不同分为治疗组(负压治疗)30例和对照组(传统打包)30例。两组患儿均于术后7d拆除敷料,常规换药至创面完全愈合。比较两组患儿植皮术后7d皮片成活率、14d创面愈合率、创面细菌感染率、术后住院时间及创面愈合时间。结果治疗组患儿的术后7d植皮成活率为(97.2±2.7)%,高于对照组(88.2±11.5)%;治疗组患儿的14d创面愈合率为(99.2±1.2)%,高于对照组(85.9±7.8)%;治疗组患儿的创面细菌感染率6.7%(2/30)低于对照组30.0%(9/30);治疗组患儿的术后住院日为(10.2±1.8)d,短于对照组(15.3±3.7)d;治疗组的创面愈合时间为(11.3±2.5)d,短于对照组(17.4±5.1)d。结论在儿童深度烧伤创面植皮术后,应用负压封闭引流技术固定移植皮片,在提高移植皮片成活率、降低术区感染率、缩短创面愈合时间及减少术后住院时间等方面优于传统固定方法。

Objectives To Compare the clinical application effect of negative pressure wound therapy （NPWT） and traditional packing compression fixation in skin grafting after deep burn wounds in children. Methods The clinical data of 60 children with deep burn wounds treated with skin grafting in Sichuan Provincial People＇s Hospital from June 2014 to June 2017 were analyzed retrospectively. Those cases were divided into the treatment group （treated with NPWT） and control group （treated with conventional packing）, and each group included 30 cases. The surgical dressings were removed 7 days after surgery and the conventional dressings were maintained until the wounds were healed completely in both groups. The two groups were compared in the survival rate of skin graft, wound healing rate at 14 days, wound bacterial infection rate, postoperative hospitalization time and wound healing time. Results The survival rate of skin graft at the 7th clay after operation in the treatment group was （97.2±2.7）%, and it was significantly higher than that in the controlgroup（88.2±11.5）%. The wound healing rate at the 14th clay after operation in the treatment group was （99.2 ~＋ 1.2）~, and it was significantly higher than that in the control group（85.9±7.8）%. The bacterial infection rate in the treatment group was 6.7%（2/30）, and it was significantly lower than that in the control group, which was 30.0%（9/30）. The postoperative hospitalization time of the treatment group was （10.2±1.8） days, and it was significantly shorter than that of the control group, which was （15.3± 3.7） days. The wound healing time in the treatment group was （11.3 ± 2.5） days, and it was significantly shorter than that in the control group, which was （17.4 ±5.1） days. Conclusion The application of NPWT for fixing the transplanted skin graft was significantly superior to the traditional method in increasing the survival rate of the transplanted skin graft, reducing the infection rate in the operation area, shortening the wound healing time and reducing the postoperative hospitalization after the skin grafting of children with deep burn wounds.