聚维酮碘喷雾联合湿性敷料换药在大疱性表皮坏死松解型药疹创面管理中的应用

Application of povidone-iodine spray combined with wet dressing dressing in the management of bullous epidermal necrolysis drug eruption

目的观察聚维酮碘喷雾联合湿性敷料换药在大疱性表皮坏死松解型药疹创面管理中的应用效果.方法在充分评估大疱性表皮坏死松解型药疹创面溃烂情况的基础上,选择合适方法对31例患儿彻底清除创面分泌物及死痂,配置0.1%聚维酮碘稀释液雾化喷洒创面,4h/次,采用软聚硅酮湿性敷料覆盖创面,每天换药一次,同时做好皮肤皱褶处护理、口腔护理、肛周护理等.结果在药物治疗的同时,所有创面均采取聚维酮碘稀释液雾化喷洒联合湿性敷料换药护理,创面均愈合良好,长出新鲜皮肤,平均新皮长出时间为(16.3±7.5)d,平均住院时间(19.1±4.3)d,其中4例患儿创面留有瘢痕,发生率为12.91%.结论采用聚维酮碘喷雾联合湿性敷料换药,可有效抑制大疱性表皮坏死松解型药疹创面感染进展,促进新鲜皮肤长出,缩短创面愈合时间,改善预后.

Objective To observe the application effect of povidone-iodine spray combined with wet dressing dressing in the management of bullous epidermal necrolysis type drug eruption wound.Methods On the basis of fully evaluating the ulceration of the bullous epidermal necrolysis type drug eruption,the appropriate method was used to completely remove the wound secretion and dead sputum from 31 children,and 0.1%povidone iodine diluted solution was sprayed onto the wound.4h/time,covered with a soft silicone wet dressing,dressing once a day,while doing skin wrinkle care,oral care,anal care.Results At the same time of drug treatment,all wounds were treated with aerosolized spray of povidone-iodine diluted solution and wet dressing.The wounds healed well and grew fresh skin.The average skin growth time was(16.3±7.5)d.The average hospital stay was(19.1±4.3)d,and 4 of them had scars on the wound surface,the incidence rate was 12.91%.Conclusion The use of povidone-iodine spray combined with wet dressing dressing can effectively inhibit the development of wound infection of bullous epidermal necrolysis type drug eruption,promote the growth of fresh skin,shorten the healing time of wounds and improve the prognosis.