论大面积烧伤感染期的诊治特点

目的：总结皮肤原位再生医疗技术在大面积特重度烧伤患者感染期的救治特点，提高烧伤皮肤原位再生医疗技术在大面积烧伤中的救治水平。方法：作者9年来分别在全国23个省市会诊抢救烧伤面积在90％以上的烧伤患者62例，均采用烧伤皮肤再生疗法救治，抢救成功最大烧伤面积100％＋口腔黏膜、食道黏膜烫伤。结果：62例严重烧伤患者，治愈60例，死亡2例，其中1例死于入院48h内暴发脓毒性休克，1例死于重度吸入性损伤继发肺部感染。结论：总结皮肤原位再生医疗技术在严重烧伤感染期的救治特点，包括感染期观察的三个“3”阶段规律和四项观测指标，强调了预防烧伤感染的原则是早期应用抗生素，在确诊感染后应及时、高效、足量的联合应用敏感抗生素，同时加强清除创面液化物等皮肤原位再生医疗技术的规范化创面处理。

Main Points of Diagnose and Management of Extensive Burns in Infective Stage

Objective： To enhance the level of burns therapy of skin regeneration in situ, the main points of treating severe extensive burns in infection stage were summarized on the basis of years of successfully clinical experience. Method： During 9 years, 62 severe burn patients with total burn area more than 90% in 23 provinces and cities of China were treated and rescued with author＇s involvement. They were all treated with burn skin regenerative therapy. The most severe burn patients rescued successfully were of 100% TBSA plus oral and esophagus mucosa scalds. Results： Of 62 patients, 60 were healed; 2 died, 1 died of septic shock outbreak within 48 hours of admission; other 1 caused by secondary pulmonary infection ceased breath resulted from severe inhalation injury. Conclusion： Main points of treating successfully severe burn patients in infective stage with skin in situ regeneration medical technique were summarized, including 3 phases and 4 observation index in infective stage. Application principle of antibiotics for this infective stage is of concentrating on prevention, and after final diagnosis of this stage, providing timely, effective, sufficient combination of antibiotics as well as strengthening standardized local treatment of burns wounds with skin in situ regeneration technique, such as timely cleaning liquefaction products.