摘要
目的:探究清创时机对深Ⅱ度烧伤创面恢复的影响。方法:选择2019年1月-2020年12月在联勤保障部队第九〇四医院苏州医疗区接受治疗的深Ⅱ度烧伤患者120例的病历资料进行回顾性分析。全部患者根据使用削痂清创时间的差异分为对照组和观察组,对照组60例,观察组60例。对照组在伤后24h以上行削痂清创手术,观察组在伤后24h以内行削痂清创手术。对比2组的围手术期相关指标(削痂清创手术耗时、手术失血量、创面愈合时间、总住院时间)、削痂清创术前和术后7d的创面细菌定植量、创面分泌物炎性因子水平[白细胞介素-8(IL-8)、白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、术后发生感染的比例。结果:观察组的创面愈合时间、总住院时间短于对照组(P<0.05)。两组的削痂清创手术耗时、手术失血量的数据差异不具有统计学意义(P>0.05)。观察组在术后7d的创面细菌定植量低于对照组(P<0.05)。观察组在术后7d的创面分泌物IL-8、IL-1、IL-6、TNF-α低于对照组(P<0.05)。两组患者术后发生感染的比例数据差异不具有统计学意义(P>0.05)。结论:出现深Ⅱ度烧伤后的患者,在伤后24h内使用削痂清创手术,更加有利于缓解创面的炎性反应,促进创面的愈合,降低创面细胞定植的风险,具有较高的临床实用价值。
Objective To explore the effect of debridement time on the recovery of deep second degree burn wound. Methods A retrospective analysis of the medical records of 120 patients with deep second-degree burns who were treated in the Suzhou Medical District of the 904 th Hospital of the Joint Logistics Support Force from January 2019 to December 2020. All patients were divided into the control group and the observation group according to the difference in the time of using scab debridement, with 60 cases in the control group and 60 cases in the observation group. The control group underwent scab debridement more than 24 h after injury, and the observation group underwent scab debridement within 24 h after injury. The perioperative indicators of the two groups were compared(time spent on scab debridement, surgical blood loss, wound healing time, total hospital stay), the amount of bacterial colonization and wound secretions before and 7 days after scab debridement Inflammatory factor levels [interleukin-8(IL-8), interleukin-1(IL-1), interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)],Proportion of postoperative infections. Results The wound healing time and total hospitalization time of the observation group were shorter than those of the control group(P<0.05). There was no statistically significant difference in the operation time and blood loss between the two groups(P>0.05). The amount of bacterial colonization in the observation group was lower than that in the control group at 7 days after operation(P<0.05). The levels of IL-8, IL-1, IL-6 and TNF-α in the wound secretion of the observation group were lower than those of the control group 7 days after operation(P<0.05). There was no significant difference in the proportion of postoperative infection between the two groups(P>0.05). Conclusion For patients with deep second-degree burns, the use of scab debridement within 24 hours after injury is more conducive to alleviating the inflammatory reaction of the wound, promoting wound healing, and reducing the risk of
作者
薛亚萍
姜春庭
丁红梅
XUE Ya-ping;JIANG Chun-ting;DING Hong-mei(Department of Burn and Plastic Surgery,Suzhou Medical District,the 904th Hospital of Joint Service Support Force,Suzhou 215006,Jiangsu,China)
出处
《中国美容医学》
CAS
2021年第11期15-19,共5页
Chinese Journal of Aesthetic Medicine
关键词
清创
烧伤
炎性反应
削痂
坏死组织
手术
感染
debridement
burns
inflammatory reaction
scab removal
necrotic tissue
surgery
infection
