烧伤感染难愈创面应用扩创植皮联合封闭负压引流技术的治疗效果

Therapeutic effect of expanded wound grafting combined with closed negative pressure drainage on refractory burn infected wounds

目的探讨烧伤感染难愈创面应用扩创植皮联合封闭负压引流技术(VSD)的治疗效果。方法选取2020年6月至2021年6月遵义医科大学第五附属(珠海)医院收治的76例大面积烧伤感染难愈创面患者作为研究对象,采用抽签法分为试验组和参照组,每组38例。参照组采用扩创植皮治疗,试验组采用扩创植皮联合VSD治疗。比较两组的移植皮片成活率、创面愈合率、创面愈合天数和换药疼痛程度,并记录不良反应发生情况。结果试验组的移植皮片成活率和创面愈合率高于参照组,差异有统计学意义(P<0.05)。试验组的创面愈合天数短于参照组,换药疼痛程度评分低于参照组,差异有统计学意义(P<0.05)。试验组的不良反应总发生率低于参照组,差异有统计学意义(P<0.05)。结论烧伤感染难愈创面应用扩创植皮联合VSD治疗,能促进创面愈合,提升植皮存活的概率,并减少并发症和后期换药的痛苦。

Objective To investigate the therapeutic effect of expanded wound grafting combined with closed negative pressure drainage(VSD)on refractory burn infected wounds.Methods A total of 76 patients with large area burn infection refractory wounds admitted to the Fifth Affiliated(Zhuhai)Hospital of Zunyi Medical University from June 2020 to June 2021 were selected as the research subjects.They were divided into experimental group and reference group by lottery,with 38 patients in each group.The reference group was treated with expanded skin grafting,and the experimental group was treated with expanded skin grafting combined with VSD.The survival rate of grafted skin,wound healing rate,wound healing days and pain degree of dressing change were compared between the two groups,and the incidence of adverse reactions was recorded.Results The graft survival rate and wound healing rate in the experimental group were higher than those in the reference group,and the differences were statistically significant(P<0.05).The wound healing days of the experimental group were shorter than those of the reference group,and the pain degree score of dressing change was lower than that of the reference group,and the differences were statistically significant(P<0.05).The total incidence of adverse reactions in experimental group was lower than that in reference group,and the difference was statistically significant(P<0.05).Conclusion Expanded skin grafting combined with VSD can promote wound healing,improve the survival rate of skin grafting,and reduce the pain of complications and late dressing change.