手部深度烧伤行创面早期切削痂和晚期切削痂植皮术的效果比较

Comparison of effects of early excision scab and late excision scab skin grafting on deep hand burns

目的比较手部深度烧伤行创面早期切削痂和晚期切削痂植皮术的效果。方法回顾性抽取2019年2月至2021年2月南石医院收治的手部深度烧伤患者100例(100只手),按照创面切削痂植皮手术时间分为早期切削痂组(伤后3~5 d,50例)和晚期切削痂组(伤后1~2周,50例)。比较两组移植成功和皮片成活情况、术后疼痛程度、血肿面积、完全愈合时间、临床效果、术后并发症。结果早期切削痂组植皮成功率高于晚期切削痂组(χ^(2)=7.44,P<0.05),皮片成活率高于晚期切削痂组(χ^(2)=9.76,P<0.05)。早期切削痂组视觉模拟评分量表评分低于晚期切削痂组(t=19.44,P<0.05),血肿面积小于晚期切削痂组(t=8.67,P<0.05),完全愈合时间短于晚期切削痂组(t=13.21,P<0.05)。早期切削痂组治疗优良率(90.00%,45/50)高于晚期切削痂组(70.00%,35/50),P<0.05。术后,早期切削痂组疼痛感、感染、手部痉挛、瘢痕形成发生率均低于晚期切削痂组(χ^(2)=11.96、8.39、6.25、14.73,P均<0.05)。结论与晚期切削痂植皮术比较,创面早期切削痂植皮术治疗手部深度烧伤效果显著,减轻术后疼痛更有效。

Objective To compare the effects of early excision scab and late excision scab skin grafting on deep hand burns.Methods A total of 100 patients(100 hands)with deep hand burns who were admitted to the Nanshi Hospital of Nanyang from February 2019 to February 2021 were retrospectively selected,and the patients were divided into early excision scab group(50 cases,receiving treatment 3-5 days after injury)and late excision scab group(50 cases,receiving treatment 1-2 weeks after injury)according to the time of excision and skin grafting.The success of transplantation,skin graft survival,postoperative pain,hematoma area,complete healing time,clinical effects,postoperative complications were compared between the two groups.Results The success rate of skin grafting in the early excision group was higher than that in the late excision group(χ^(2)=7.44,P<0.05),and the skin graft survival rate in the early excision group was higher than that in the late excision group(χ^(2)=9.76,P<0.05).The visual analogue scale score in the early excision group was lower than that in the late excision group(t=19.44,P<0.05),the area of hematoma in the early excision group was smaller than that in the late excision group(t=8.67,P<0.05),and the complete healing time in the early excision group was shorter than that of the late excision group(t=13.21,P<0.05).The excellent and good rate in the early excision group(90.00%,45/50)was higher than that in the late excision group(70.00%,35/50),P<0.05.After surgery,the incidence of pain,infection,hand spasm,and scarring in the early excision group were lower than those in the late excision group(χ^(2)=11.96,8.39,6.25,14.73;all P<0.05).Conclusions Compared with the late excision scab skin grafting,the early excision scab skin grafting on the wound surface is more effective in treating deep burns of the hand,and it is more effective in reducing postoperative pain.