脱细胞异种(猪)真皮早期覆盖治疗Ⅱ度烧伤创面的临床研究

目的 观察脱细胞异种(猪)真皮早期覆盖治疗Ⅱ度烧伤创面的疗效.方法 65例Ⅱ度烧伤患者按随机数字表法随机分为两组,实验组33例在烧伤后6 h内清创,然后用脱细胞异种(猪)真皮覆盖封闭创面并包扎中途不换药;对照组32例烧伤后6 h内常规清创,然后用聚维酮碘软膏纱布覆盖创面并包扎,每2～3 d换药1次,比较两组创面愈合时间、创面覆盖3 d后血浆总蛋白及白蛋白水平、创面细菌检出率以及愈合质量的差异.结果 实验组浅Ⅱ度及深Ⅱ度偏浅创面的愈合时间分别为(8.1±1.2)d及(14.3±2.7)d,均快于对照组的(13.2±2.3)d及(19.4±3.4)d,(P均＜0.05);实验组创面细菌检出率为9.1%,明显低于对照组的31.2%,差异有统计学意义(P＜0.05);两组创面覆盖前的血清总蛋白及白蛋白水平差异无统计学意义(P均＞0.05),覆盖3 d后实验组的白蛋白及总蛋白明显低于对照组(P＜0.01).实验组的创面愈合质量好于对照组.结论 脱细胞异种(猪)真皮早期覆盖治疗Ⅱ度烧伤创面疗效可靠,方法简便易操作,具有推广应用价值.

Treatment of Second-degree Burns with Early Xenogenic Porcine Acellular Dermal Matrix Covering

Objective To investigate the effectiveness of early xenogenic porcine acellular dermal matrix covering in the treatment of second-degree burns.Methods 65 patients suffering from second-degree burns were randomly divided into two groups:the experimental group and controls.All the patients were removed the necrotic epidermis and washed with normal saline and 0.5% povidone-iodine(PVP-I)under anesthesia in 6 hours after they were wounded.Patients in the experimental group(n=33)were covered on the superficial or medium partial-thickness burns wounds with xenogenic porcine acellular dermal matrix,wrapped without dressing change,and patients in the control group were wrapped and fixed with cotton gauze pretreated by PVP-I,dressing change of every one or two days.Results In the experimental group,the superficial second-degree burns were healed in 8.1±1.2 days and deep second-degree burns in 14.3±2.7 days,and the controls were healed in 13.2±2.3 days for those patients with superficial second-degree burns and 19.4±3.4 days for deep second-degree burns(P<0.05).The infection rate in experimental group was significantly lower than the controls(9.1% vs 31.2%,P<0.05).The plasma proteins and albumin concentration had no significant difference between two groups before surgery(P>0.05);but three days after surgery,those in the experimental group were significantly lower than the controls(P<0.01).The experimental group was superior to the control group in scar formation and healing quality.Conclusion Xenogenic porcine acellular dermal matrix covering is efficient,safe and easy-operating for the treatment of early second-degree burns,which is worthy of clinical application.