亚甲蓝染色技术在外科清创中的临床应用

Clinical application of methylene blue staining technique in surgical debridement

目的 探讨亚甲蓝组织染色技术指导外科清创的临床应用方法及体会。方法 回顾性分析自2020年1月至2023年1月,合肥市第二人民医院烧伤整形外科收治的39例体表创面患者资料,将亚甲蓝涂抹至开放性创面,或用注射器将亚甲蓝注入窦道内,失活组织即被染成蓝色,直视下进行清创及窦道切除,之后采用皮瓣移植修复创面。观察术后1~2周术区皮瓣颜色、渗出液性状、切口愈合情况等。结果 39例患者中2例出现缝合处部分皮瓣边缘结痂及水疱,其余患者皮瓣无红肿,皮瓣下无积液积脓,术后2周拆线。出院后1、3个月随访,患者术区愈合稳定。结论 采用亚甲蓝染色指导清创可使手术视野更直观,提高清创效率及创面一期愈合率,临床效果值得肯定。

Objective To explore the clinical application and experience of methylene blue tissue staining technique to guide surgical debridement.Methods The data of 39 patients with body surface wounds admitted to our department from January 2020 to Jan-uary 2023 were reviewed.Methylene blue tissue staining technique was applied to guide surgical debridement,methylene blue was applied to open wounds,or methylene blue was injected into the sinus with a syringe,and the debridement and sinus resection were performed un-der direct vision.After debridement,skin flap was used to repair the wound.The skin flap color,exudate character and incision healing were observed 1-2 weeks after operation.Results A total of 39 patients,2 cases of the suture part of the skin flap edge scab and blister formation,the rest of the skin flap without redness and swelling,no fluid accumulation under the flap,suture healing about two weeks after surgery.One month after discharge and three months after follow-up telephone survey,the patient's operative area healed stable.Conclu-sion The debridement guided by methylene blue staining can make the visual field more intuitive,improve the debridement efficiency and the first-stage wound healing rate,and the clinical effect is worthy of recognition.