封闭负压引流联合胶原蛋白海绵治疗深Ⅱ度烧伤创面的疗效观察

Efficacy of Vacuum-assisted Closure Combined with Collagen Sponge in Treating Deep Ⅱ Degree Burn Wounds

目的:观察封闭负压引流联合胶原蛋白海绵对深Ⅱ度烧伤创面的临床疗效。方法:将烧伤面积小于15%TBSA的深Ⅱ度烧伤患者100例随机分为对照组(C组)、负压吸引组(V组)、胶原蛋白海绵组(CS组)和负压吸引联合胶原蛋白组(V-CS组)。C组创面采用常规换药治疗(生理盐水清洗、碘伏消毒、凡士林纱布包扎)。V组创面采用负压吸引治疗,第1疗程安置负压吸引7d,负压值约-120mmHg,如创面未愈合,采取常规换药1次,隔3天后重复上述治疗。CS组采用胶原蛋白海绵换药治疗,每3天更换一次胶原蛋白。V-CS组采用负压吸引联合胶原蛋白海绵治疗,将胶原蛋白海绵置于创面,同时行封闭负压引流治疗。观察各组患者创面愈合过程中第1、4、7、14、21天的创面分泌物细菌培养阳性率、不同时相创面的愈合面积比率差异。结果:从治疗后第7天始,V、CS组及V-CS组的细菌培养阳性病例均低于对照组,且第10、14天时V-CS组细菌培养阳性率最低,V、CS组及V-CS组第10、14、21天的细菌培养阳性率与对照组比较,差异均有统计学意义(P<0.05)。。在治疗后第10、14、21天,V-CS组的创面愈合比率均大于C、V组及CS组,有统计学差异(P<0.05)。同期,V组与CS组创面愈比率大于对照组,差异有统计学意义(P<0.05)。结论:封闭负压引流和合胶原蛋白海绵都是治疗深Ⅱ度烧伤创面的有效手段,两种方法同时结合使用时,减少创面细菌阳性和促进创面快速愈合的作用更显著。

Objective:To observe and explore the clinical effect of vacuum-assisted closure combined with collagen sponge in deep Ⅱ degree burn wounds.Methods:One hundred patients with deep partial thickness burn wound are randomly divided into control group(Group C),vacuum-assisted closure group(Group V),collagen sponge group(Group CS)and vacuum-assisted closure combined with collagen group(Group v-CS).Group C is treated with routine dressing change(saline cleaning,iodophor disinfection,vaseline gauze bandaging).The wounds in Group V are treated by negative pressure suction and the negative pressure value is-120 mmHg in the first course of treatment(7 days).The second course of treatment should be started three days later.Collagen sponges are usedto treat CS and is replaced every 3 days.Group V-CS is treated with negative pressure suction and collagen sponge at the same time.The positive rate of bacterial culture in wound secretion and the healing area ratio of wound at different times and groups are observed on the 1 st,4 th,7 th,14 th and21 st day of wound healing.Results:it is started 7 days later of treatment,the positive rate of bacterial culture in Groups V,CS and V-CS is lower than that in control group(P<0.05).The positive rate of bacterial culture in Groups V,CS and Group is lower than that in control group on the 14 th and 21 th days(P<0.05).On the 14 th day,the positive rate of bacterial culture in Groups V-CS is the lowest(P<0.05).On the 10 th,14 th and 21 th days,the wound healing rate of Groups V,CS and V-CS is higher than that of control group,Groups V and CS(P<0.05).At the same time,the wound healing rate in Groups V and CS is higher than that in control group(P<0.05).Conclusion:Vacuum-assisted closure and collagen sponge are both effective methods for treating deep partial burn wounds,at the same time,the two methods can reduce the bacteria of wound and promote the rapid healing of wound.