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中华损伤与修复杂志(电子版) ›› 2023, Vol. 18 ›› Issue (02) : 123 -127. doi: 10.3877/cma.j.issn.1673-9450.2023.02.006

论著

采用超声清创联合负压吸引疗法治疗深度烧伤溶痂创面的临床观察
何泽亮1, 李锦1, 张程亮1, 随振阳1, 安亮恩1, 刘玲玲1, 姚媛媛1, 张聚磊1, 仇树林1, 李晓东1,()   
  1. 1. 050082 石家庄,中国人民解放军联勤保障部队第九八〇医院烧伤整形科
  • 收稿日期:2022-09-22 出版日期:2023-04-01
  • 通信作者: 李晓东
  • 基金资助:
    河北省医学科学研究课题计划项目(20211620); 河北省自然科学基金项目(H2020505007)

Application of ultrasonic debridement combined with negative pressure wound therapy in deep burn wound with dissolved scab

Zeliang He1, Jin Li1, Chengliang Zhang1, Zhenyang Sui1, Liangen An1, Lingling Liu1, Yuanyuan Yao1, Julei Zhang1, Shulin Qiu1, Xiaodong Li1,()   

  1. 1. Department of Burn and Plastic Surgery, 980th Hospital of the Chinese People′s Liberation Army Joint Logistic Support Force, Shijiazhuang 050082, China
  • Received:2022-09-22 Published:2023-04-01
  • Corresponding author: Xiaodong Li
引用本文:

何泽亮, 李锦, 张程亮, 随振阳, 安亮恩, 刘玲玲, 姚媛媛, 张聚磊, 仇树林, 李晓东. 采用超声清创联合负压吸引疗法治疗深度烧伤溶痂创面的临床观察[J]. 中华损伤与修复杂志(电子版), 2023, 18(02): 123-127.

Zeliang He, Jin Li, Chengliang Zhang, Zhenyang Sui, Liangen An, Lingling Liu, Yuanyuan Yao, Julei Zhang, Shulin Qiu, Xiaodong Li. Application of ultrasonic debridement combined with negative pressure wound therapy in deep burn wound with dissolved scab[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2023, 18(02): 123-127.

目的

探讨超声清创联合负压吸引疗法应用于深度烧伤溶痂创面的临床疗效。

方法

采用临床随机对照试验,选择2018年4月至2022年4月中国人民解放军联勤保障部队第九八〇医院烧伤整形科收治的深度烧伤出现溶痂创面的患者61例,根据随机数字表法将患者分为治疗组31例、对照组30例。治疗组采用超声清创联合负压吸引疗法治疗,对照组采用传统换药治疗,创面每2~3 d换药,并给予传统手术清创,两组创面清创后均行皮片移植。统计两组患者住院时间、清创术后第3天细菌清除率、伤后植皮时间、植皮术后第7天皮片成活率和血肿发生率。

结果

治疗组患者住院时间(34.16±3.33)d显著短于对照组(43.17±5.43)d,细菌清除率90.91%(40/44)显著高于对照组73.81%(31/42),伤后植皮时间(22.09±2.62)d显著短于对照组(28.50±4.02)d,皮片成活率(92.58±3.35)%显著高于对照组(82.56±6.05)%,血肿发生率9.68%(3/31)显著低于对照组36.67%(11/30)(P<0.05)。

结论

超声清创联合负压吸引疗法在深度烧伤溶痂创面中临床效果显著,可显著降低创面细菌负荷,提高皮片成活率,促进创面愈合,缩短病程,值得临床推广。

Objective

To investigate the clinical effect of ultrasonic debridement combined with negative pressure wound therapy in the deep burn wound with dissolved scab.

Methods

Clinical randomized controlled trial was conducted. From April 2018 to April 2022, 61 patients with deep burn wounds with dissolved scab admitted to the Burn and Plastic Surgery Department of the 980th Hospital of Joint Logistic Support Force were selected and divided into the treatment group (31 cases) and the control group (30 cases) according to the random number table method. The treatment group was treated with ultrasonic debridement combined with negative pressure wound therapy, while the control group was treated with traditional dressing change therapy, dressing change every 2-3 days, and traditional surgical debridement. Skin grafts were performed after wound debridement in both groups. The length of hospital stay, bacterial clearance rate on the 3rd day after debridement, skin grafting time after injury, skin graft survival rate on the 7th day after skin grafting and the incidence of hematoma were recorded.

Results

The hospital stay of the treatment group (34.16±3.33) d was significantly shorter than that of the control group(43.17±5.43)d, the bacterial clearance rate of 90.91% (40/44) was significantly higher than that of the control group 73.81% (31/42), and the skin grafting time after injury(22.09±2.62)d was significantly shorter than that of the control group(28.50±4.02)d. The skin survival rate (92.58±3.35)% was significantly higher than that of the control group (82.56±6.05)%, and the incidence of hematoma (9.68%, 3/31) was significantly lower than that of the control group (36.67%, 11/30).

Conclusion

Ultrasonic debridement combined with negative pressure wound therapy has a significant clinical effect in deep burn wound with dissolved scab, which can significantly reduce the bacterial load of wounds, improve the survival rate of skin grafts, promote wound healing, and shorten the course of the disease, which is worthy of clinical promotion.

表1 两组患者一般资料比较
表2 两组创面情况比较(±s)
图1 患者术前及术后情况。A示伤后第10天清创术前情况,见部分创面溶痂,部分干痂附着,可见栓塞血管;B示清创术后给予负压吸引治疗;C示超声清创联合负压吸引治疗7 d后情况,见创基红润,肉芽组织增生;D示植皮术后第7天见皮片成活良好
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