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对腋窝烧伤后瘢痕挛缩畸形患者采用局部皮瓣转移加中厚皮片移植修复及康复治疗,随访观察结果局部皮瓣及移植皮片成活良好。肩关节外展和旋转正常。 相似文献
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This article analyzed the medical records of a patient with 90% TBSA unhealed wound accompanied with wound sepsis 50 days post burn (PBD) and to discuss the ideal strategies of treatment for such patients in such condition.This was a 24-year-old male patient suffering from flame burn with 95% TBSA wound and severe inhalation injury.Meek skin grafting with autologous scalp was performed once to the thoracic and abdominal regions; intermingled skin grafting of autologous scalp microskin and large sheet of allograft was performed twice to the limbs within PBD 31.The patient was transferred to our hospital on PBD 50 with 90% TBSA wound unhealed,leaving a vast amount of necrotic tissue and allografts.Furthermore,he was complicated by sepsis,pulmonary infection,and gastric ulcer.Debridement and allogenic skin grafting were performed on the first day after hospitalization.When the condition of wounds was improved,transplantation of a large sheet of allogenic skin with inlaid small pieces of autologous skin,intermingled skin grafting of autologous and allogenic skin,and small pieces of autologous skin grafting were performed.Because of the shortage of donor area,the exposed wounds were temporarily covered with allogeneic skin.Epidermal growth factor was used to promote the healing of autologous skin donor site and deep partial-thickness bum wound.Autologous skin grafting was performed whenever source of healthy skin was available.Systemic use of effective antibiotics,nutritional support and therapy,and other comprehensive measures also contributed to the success of treatment of this patient suffering from wound sepsis.The patient was cured and discharged on PBD 145. 相似文献
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目的 探讨关于严重烧伤合并急性感染性心内膜炎的早期诊断和预防措施.方法 通过比较分析严重烧伤合并感染性心内膜炎患者不同时期的临床表现、实验室检查结果、心脏病变情况,以及血液、深静脉置管和创面等不同部位的细菌培养结果之间的相关性和差异性.结果 本组3例患者均表现为持续高热,血液、深静脉和导管等细菌培养结果为金黄色葡萄球菌或念珠菌,心脏瓣膜形成赘生物,最终救治无效而死亡.结论 严重烧伤容易引发全身感染,进而发展成为感染性心内膜炎,治疗棘手,病死率高.手术是挽救生命的唯一方法,其治疗重点在于早期预防、早期诊断. 相似文献
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Objective To study the effect of cotransfection of genes of insulin-like growth factor I (IGF-I) and herpes simplex virus thymidine kinase (HSV-tk) on wound healing. Methods Thirty male Wistar rats were inflicted with 30% TBSA full-thickness scald. They were then divided into A group (4. 6 μg pcDNA3.1/IGF- I + Lipofectmine 2000 + saline) , B group (3.6 μg pcDNA3. 1/HSV-tk + Lipo-fectmine 2000 + saline) , C1 group and C2 group (2. 3 μg pcDNA3.1/IGF-I + 1. 8 μg pcDNA3. 1/HSV-tk + Lipofectmine 2000 + saline) , and D group (3.0 μg pcDNA3. 1 + Lipofectmine 2000 + saline) according to the random number table, with 6 rats in each group. The above-mentioned mixtures were subcutaneously injected into left back of each rat the moment after injury and on post scald day (PSD) 7, 14, 21 , and 28. Gancyclovir (2.5 mg/100 g) was hypodermically injected into rats in C2 group on PSD 29, 30, 31, 32. Changes in body weight of rats were measured. Wound healing rates were calculated. On PSD 35, the expressions of IGF- I gene in local wound and liver tissue were determined with immunohistochemical staining. The serum expression of IGF- I was determined with radioimmunoassay. Expression of HSV-tk gene in local wound was determined with RT-PCR. Apoptosis of fibroblast in C1 and C2 groups was observed under transmission electron microscope. Data were processed with one-way analysis of variance and Turkey method. Results Body weight of rats in A, C1, and C2 groups increased from PSD 7 through 35, and the difference between former three groups and B, D groups was statistically significant (with F value respectively 2.764, 4.519, 5.009, 13.449, 5.877, P values all below 0.05). Wound healing rates of rats in A, C1, and C2 groups were higher than those in B, D groups (with F value respectively 5.286, 100. 880, 152.380, 127.850, 147. 750, P values all below 0.05). IGF-I gene was positively expressed in wound fi-broblast in A, C1 and C2 groups, but negatively in liver tissues of all the rats. There was no significant statistical difference among groups in serum content of IGF-I [from (1185 ± 170) to (1270 ± 130) ng/mL, F = 0. 355, P =0. 838]. HSV-tk gene was positively expressed in rat skin tissue in B, C1 and C2 groups. Fi-broblast apoptosis was observed under transmission electron microscope in C2 group, but it was not observed in C1 group. Conclusions Cotransfection of pcDNA3.1/IGF- I and pcDNA3.1/HSV-tk mediated by li-posome can promote wound healing, and inhibit the scar proliferation to some extent. 相似文献
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The treatment of extensive severe burn injury is very difficult, especially when some complications are involved. A burned patient sustained 98% total body surface area (TBSA) with 95% full thickness burn and severe inhalation injury was admitted to our hospital in August 2000. After aggressive treatment, the patient recovered fully. This paper reports the treatment of the patient. 相似文献
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