BACKGROUND Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence.They require immediate and appropriate management before they progress to an irrever...BACKGROUND Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence.They require immediate and appropriate management before they progress to an irreversible condition.Although negative pressure wound therapy(NPWT)can prevent wound progression by increasing microcirculation,the inappropriate application of NPWT on complicationthreatened transferred and replanted tissues can induce an adverse effect.CASE SUMMARY A 48-year-old woman who underwent immediate breast reconstruction with a deep inferior epigastric artery perforator free flap.While applying a heating pad directly to the flap site,she sustained a deep second to third-degree contact burn over 30%of the transferred flap on postoperative 7 d.As the necrotic changes had progressed,we applied an NPWT dressing over the burned area after en-bloc debridement of the transferred tissues on postoperative 21 d.After 4 d of NPWT application,the exposed fatty tissues of the flap changed to dry and browncolored necrotic tissues.Upon further debridement,we noted that the wound gradually reached total necrosis with a collapsed vascular pedicle of deep inferior epigastric artery.CONCLUSION Although NPWT has been shown to be successful for treating various wound types,the significant risk of NPWT application in short-lasting reconstructed flap wounds after thermal injury should be reminded.展开更多
目的:探究基于行动研究法的健康管理联合负压封闭引流(Vacuum sealing drainage,VSD)技术对深度烧伤患者心理状态及创面修复效果的影响。方法:选取2021年9月-2023年6月笔者科室收治的98例深度烧伤患者,经随机单双号法分为常规组(单号,n=...目的:探究基于行动研究法的健康管理联合负压封闭引流(Vacuum sealing drainage,VSD)技术对深度烧伤患者心理状态及创面修复效果的影响。方法:选取2021年9月-2023年6月笔者科室收治的98例深度烧伤患者,经随机单双号法分为常规组(单号,n=49)和行动法组(双号,n=49),两组均实施VSD技术治疗,常规组采用常规护理干预,行动法组采用基于行动研究法的健康管理。比较两组患者疾病认知水平、负性情绪[自我感受负担量表(Self-perceived burden scale,SPBS)]、伤残接受度[伤残接受度量表(Acceptance of disability scale,AODS)]、生活质量[中文版精简烧伤健康量表(Burn specific health scale-brief,BSHS-B)]、创面美观度[温哥华瘢痕量表(Vancouver scar scale,VSS)]评分及护理满意度。结果:干预后,行动法组患者对疾病的认知情况评分、AODS、BSHS-B评分及护理满意度均高于常规组,SPBS、VSS评分均低于常规组,差异均有统计学意义(P<0.05)。结论:对行VSD治疗的深度烧伤患者采用基于行动研究法的健康管理,可明显提高患者的疾病认知和伤残接受度,调节其负性情绪,利于创面外观恢复及生活质量提升,患者满意度较高,值得推荐。展开更多
Burns are a main cause of accidental injuries among children in China.Because of the unique wound repair capacity and demand for growth in pediatric patients,the management of pediatric deep partial-thickness burn wou...Burns are a main cause of accidental injuries among children in China.Because of the unique wound repair capacity and demand for growth in pediatric patients,the management of pediatric deep partial-thickness burn wounds involves a broader range of treatment options and controversy.We assembled experts from relevant fields in China to reach a consensus on the key points of thermal-induced pediatric deep partial-thickness burn-wound management,including definition and diagnosis,surgical treatments,nonsurgical treatment,choice of wound dressings,growth factor applications,infectious wound treatment,scar prevention and treatment.The committee members hope that the Expert Consensus will provide help and guiding recommendations for the treatment of pediatric deep partial-thickness burn wounds.展开更多
目的探讨自体富血小板凝胶(APG)结合封闭负压引流(VSD)对深Ⅱ度烧伤患者创面愈合进程及表皮生长因子(EGF)、碱性成纤维细胞生长因子(bFGF)水平的影响。方法选取2018年7月—2021年7月在南通大学附属南通第三医院就诊的82例深Ⅱ度烧伤患...目的探讨自体富血小板凝胶(APG)结合封闭负压引流(VSD)对深Ⅱ度烧伤患者创面愈合进程及表皮生长因子(EGF)、碱性成纤维细胞生长因子(bFGF)水平的影响。方法选取2018年7月—2021年7月在南通大学附属南通第三医院就诊的82例深Ⅱ度烧伤患者作为研究对象,按随机数字表法分为观察组(APG结合VSD治疗)和对照组(VSD治疗),各41例。比较两组患者的疗效、创面愈合时间、肉芽生长面积、创面愈合率、住院时间、并发症,比较两组患者治疗前后的EGF、bFGF、C反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞计数(WBC)、疼痛视觉模拟评分(VAS)的差值及治疗后1个月、2个月的温哥华瘢痕量表(VSS)评分的差值。结果观察组总有效率高于对照组(P<0.05)。观察组创面愈合时间、住院时间少于对照组,肉芽生长面积大于对照组,创面愈合率高于对照组(P<0.05)。观察组治疗前后EGF、bFGF、CRP、IL-6、WBC的差值高于对照组(P<0.05)。观察组治疗前与治疗后14 d VAS评分及治疗后1个月与2个月VSS评分的差值高于对照组(P<0.05)。两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论APG结合VSD治疗深Ⅱ度烧伤可加快患者创面愈合进程,提高EGF、bFGF水平,减轻炎症反应和疼痛,减少瘢痕增生,且并发症少。展开更多
文摘BACKGROUND Thermal injuries on free transferred or replanted tissues resulting from loss of sensibility are an infrequent occurrence.They require immediate and appropriate management before they progress to an irreversible condition.Although negative pressure wound therapy(NPWT)can prevent wound progression by increasing microcirculation,the inappropriate application of NPWT on complicationthreatened transferred and replanted tissues can induce an adverse effect.CASE SUMMARY A 48-year-old woman who underwent immediate breast reconstruction with a deep inferior epigastric artery perforator free flap.While applying a heating pad directly to the flap site,she sustained a deep second to third-degree contact burn over 30%of the transferred flap on postoperative 7 d.As the necrotic changes had progressed,we applied an NPWT dressing over the burned area after en-bloc debridement of the transferred tissues on postoperative 21 d.After 4 d of NPWT application,the exposed fatty tissues of the flap changed to dry and browncolored necrotic tissues.Upon further debridement,we noted that the wound gradually reached total necrosis with a collapsed vascular pedicle of deep inferior epigastric artery.CONCLUSION Although NPWT has been shown to be successful for treating various wound types,the significant risk of NPWT application in short-lasting reconstructed flap wounds after thermal injury should be reminded.
文摘目的:探究基于行动研究法的健康管理联合负压封闭引流(Vacuum sealing drainage,VSD)技术对深度烧伤患者心理状态及创面修复效果的影响。方法:选取2021年9月-2023年6月笔者科室收治的98例深度烧伤患者,经随机单双号法分为常规组(单号,n=49)和行动法组(双号,n=49),两组均实施VSD技术治疗,常规组采用常规护理干预,行动法组采用基于行动研究法的健康管理。比较两组患者疾病认知水平、负性情绪[自我感受负担量表(Self-perceived burden scale,SPBS)]、伤残接受度[伤残接受度量表(Acceptance of disability scale,AODS)]、生活质量[中文版精简烧伤健康量表(Burn specific health scale-brief,BSHS-B)]、创面美观度[温哥华瘢痕量表(Vancouver scar scale,VSS)]评分及护理满意度。结果:干预后,行动法组患者对疾病的认知情况评分、AODS、BSHS-B评分及护理满意度均高于常规组,SPBS、VSS评分均低于常规组,差异均有统计学意义(P<0.05)。结论:对行VSD治疗的深度烧伤患者采用基于行动研究法的健康管理,可明显提高患者的疾病认知和伤残接受度,调节其负性情绪,利于创面外观恢复及生活质量提升,患者满意度较高,值得推荐。
基金Shanghai Directed Projects of Biopharmaceutical Field(22DX1900600)Shanghai Research Center for Burn and Wound Repair(2023ZZ02013)Shanghai Municipal Key Clinical Specialty of China(shslczdzk02302).
文摘Burns are a main cause of accidental injuries among children in China.Because of the unique wound repair capacity and demand for growth in pediatric patients,the management of pediatric deep partial-thickness burn wounds involves a broader range of treatment options and controversy.We assembled experts from relevant fields in China to reach a consensus on the key points of thermal-induced pediatric deep partial-thickness burn-wound management,including definition and diagnosis,surgical treatments,nonsurgical treatment,choice of wound dressings,growth factor applications,infectious wound treatment,scar prevention and treatment.The committee members hope that the Expert Consensus will provide help and guiding recommendations for the treatment of pediatric deep partial-thickness burn wounds.
文摘目的探讨自体富血小板凝胶(APG)结合封闭负压引流(VSD)对深Ⅱ度烧伤患者创面愈合进程及表皮生长因子(EGF)、碱性成纤维细胞生长因子(bFGF)水平的影响。方法选取2018年7月—2021年7月在南通大学附属南通第三医院就诊的82例深Ⅱ度烧伤患者作为研究对象,按随机数字表法分为观察组(APG结合VSD治疗)和对照组(VSD治疗),各41例。比较两组患者的疗效、创面愈合时间、肉芽生长面积、创面愈合率、住院时间、并发症,比较两组患者治疗前后的EGF、bFGF、C反应蛋白(CRP)、白细胞介素6(IL-6)、白细胞计数(WBC)、疼痛视觉模拟评分(VAS)的差值及治疗后1个月、2个月的温哥华瘢痕量表(VSS)评分的差值。结果观察组总有效率高于对照组(P<0.05)。观察组创面愈合时间、住院时间少于对照组,肉芽生长面积大于对照组,创面愈合率高于对照组(P<0.05)。观察组治疗前后EGF、bFGF、CRP、IL-6、WBC的差值高于对照组(P<0.05)。观察组治疗前与治疗后14 d VAS评分及治疗后1个月与2个月VSS评分的差值高于对照组(P<0.05)。两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论APG结合VSD治疗深Ⅱ度烧伤可加快患者创面愈合进程,提高EGF、bFGF水平,减轻炎症反应和疼痛,减少瘢痕增生,且并发症少。
