封闭负压治疗技术不同压力值对深度烧伤创面移植皮片成活影响的临床研究

A clinical study on the effect of different pressure values of NPWT on the survival of skin grafts for deep burn wounds

目的探讨深度烧伤创面植皮术后外加不同强度封闭负压治疗对移植皮片成活的影响。方法我院收治的深度烧伤需行植皮术患者60例,按随机数字表示分为6组,入院后2~3 d安排清创植皮手术,术后分别采用不同固定方式及不同压力强度固定皮片。比较6组患者植皮术后第7天创面皮片成活率、创面分泌物细菌培养阳性率,14天创面愈合率及创面愈合时间。结果烧伤创面植皮术后封闭负压治疗技术组(B^F组)7天创面皮片成活率、14天创面愈合率、创面愈合时间均优于传统包扎治疗组(A组);其中以C、D、E组结果最优(P<0.05)。A组与D组术后7天移植皮片血管化差异无统计学意义(P>0.05)。结论烧伤创面植皮术后应用负压封闭引流技术可以促进植皮创面愈合,尤以压力强度75~125 mm Hg为佳。

Objective To investigate the effect of negative pressure therapy with different intensities on the survival of transplanted skin after deep bum wound with skin flap grafting.Methods We divided 60 patients with deep bum wounds who needed skin grafting therapy in our hospital into six groups.The patients received the degenerative surgery and dermatography after 2 to 3 days of ad-mission.After the operation,the skin grafts were fixed with different fixed methods and different pressure strengths.The 7-days survival rate of the skin grafts,the positive rate of bacterial culture of wound secretions,and the 14-days wound healing rate and healing time were compared among the six groups.Results After burn wound with skin flap grafting,the 7 -days survival rate of the skin grafts and the 14-days wound healing rate and healing time in the negative pressure wound treatment （NPWT） groups （B to F） were better than those in the traditional dressing treatment group （ group A） , among which the results were the best in the groups of C, D and E （ P 〈0.05） .However,there was no significant difference in vascularization of the skin graft after 7 days of the operation between groups of A and D （P 〉0.05 ）.Conclusion Application of negative pressure occlusion and drainage after bum wound with skin flap grafting can promote the skin wound healing.Especially, the pressure intensity at 75 - 125 mmHg is better.