清创联合负压封闭引流治疗对深Ⅱ度烧伤病人创面愈合及感染情况的影响

Effect of debridement combined with negative pressure wound therapy on wound healing and infection in patients with deep second-degree burn

目的探讨清创联合负压封闭引流技术(VSD)治疗对深Ⅱ度烧伤病人创面愈合及感染情况的影响。方法2018年3月~2021年3月本院收治的深Ⅱ度烧伤病人90例,根据治疗意愿分为两组,对照组49例,行清创联合常规换药治疗,观察组41例,行清创联合VSD治疗,比较两组病人创面愈合情况。结果观察组完全愈合时间为(23.48±4.27)天,明显短于对照组的(26.57±3.84)天,两组比较差异有统计学意义(P<0.05)。观察组和对照组7天(T_(1))、14天(T_(2))、21天(T_(3))时创面愈合率分别为(14.64±3.27)%和(11.57±3.51)%,(54.38±10.63)%和(40.41±9.58)%,(75.26±8.47)%和(62.19±9.03)%,差异有统计学意义(P<0.05),观察组和对照组VAS评分分别为(3.54±1.27)分和(4.75±1.13)分,(2.24±0.78)分和(3.05±0.81)分,(1.84±0.56)分和(2.47±0.62)分,两组比较差异有统计学意义(P<0.05)。T_(1)时,观察组和对照组创面红肿分别为(41.46%和63.27%,创面分泌物发生率分别为(43.90%和63.27%,两组比较差异有统计学意义(P<0.05);T_(1)、T_(2)时,观察组和对照组创面感染率分别为2.42%和20.41%、0.00%和14.29%,细菌培养阳性率分别为4.89%和26.53%、2.42%和18.37%,两组比较差异有统计学意义(P<0.05);术后半年,观察组和对照组瘢痕发生率分别为14.63%和36.73%、VSS评分分别为(5.64±1.53)分和(8.25±2.17)分,两组比较差异有统计学意义(P<0.05)。结论清创联合VSD治疗能有效提高深Ⅱ度烧伤病人的创面愈合率,缩短创面愈合时间,降低创面感染率及伤口疼痛水平,减少瘢痕的发生。

Objective To investigate the effect of debridement combined with negative pressure wound therapy on wound healing and infection in patients with deep second-degree burn.Methods Ninety patients with burn treated in the hospital from March 2018 to March 2021 were selected as the research subjects.Among them,49 patients treated with debridement combined with routine dressing change were included in the control group,while 41 patients treated with debridement combined with negative pressure wound therapy were included in the observation group.Wound healing status was compared between the two groups.Results The complete healing time of the observation group was significantly shorter than that of the control group[(23.48±4.27)d vs.(26.57±3.84)d](P<0.05).The wound healing rates in the observation group at T_(1),T_(2)and T_(3)were higher than those of the control group[(14.64±3.27)%vs.(11.57±3.51)%,(54.38±10.63)%vs.(40.41±9.58)%,(75.26±8.47)%vs.(62.19±9.03)%],and VAS scores were lower than those of the control group[(3.54±1.27)vs.(4.75±1.13),(2.24±0.78)vs.(3.05±0.81),(1.84±0.56)vs.(2.47±0.62)](P<0.05).At T_(1),the incidences of wound redness and secretion in the observation group were lower than those in the control group(41.46%vs.63.27%,43.90%vs.63.27%)(P<0.05).The wound infection rates and positive rates of secretion bacterial culture in the observation group at T_(1)and T_(2)were lower than those in the control group(2.42%vs.20.41%,0.00%vs.14.29%;4.89%vs.26.53%,2.42%vs.18.37%)(P<0.05).At 6 months after treatment,the incidence of scar and VSS score in the observation group were lower than those in the control group[14.63%vs.36.73%,(5.64±1.53)vs.(8.25±2.17)](P<0.05).Conclusion Debridement combined with negative pressure wound therapy can effectively improve wound healing rate in patients with deep second-degree burn,shorten wound healing time,and reduce wound infection rate,wound pain and scar formation.