负压封闭引流辅助治疗深度电烧伤创面15例

目的:分析、寻找电烧伤创面的处理方法.方法:对2008年10月-2009年5月收治的电烧伤后使用负压封闭引流技术处理创面的病人总结分析.结果:使用负压封闭引流后,创面消肿快,感染低,创面肉芽生长旺盛,并发症少.结论:负压封闭引流技术对于重度电烧伤的创面处理是较好的选择.     

应用表皮生长因子治疗深Ⅱ度烧伤创面的远期临床疗效观察

目的　观察重组人表皮生长因子 (rhEGF)用于深Ⅱ度烧伤创面治疗的远期疗效及安全性。　方法　对 37例烧伤患者进行随机、双盲、同体对照实验 ,每例患者选择一块深Ⅱ度烧伤创面 ,并将其分为面积相近的两部分 ,于伤后第 1天开始分别用单纯等渗盐水 (对照组 )和含rhEGF的等渗盐水 (治疗组 )进行换药治疗。创面愈合后 1、4年时 ,对各患者进行院外随访 ,采用改良温哥华瘢痕测量法 ,评价上述受试创面愈合后的瘢痕指数 (SI)。　结果　 1年后随访时 ,治疗组SI为 7.19± 1.6 7,明显小于对照组 8.92± 1.78(P <0 .0 1) ;4年后随访时 ,治疗组SI为 6 .12± 1.5 4 ,明显小于对照组 8.0 9± 1.81(P <0 .0 1)。所有受试创面均无肿瘤形成、癌变等并发症发生。　结论　外用rhEGF治疗深Ⅱ度烧伤创面 ,能明显减少后期瘢痕的形成 ,远期疗效和安全性较好。     

应用负压封闭引流技术治疗复杂创面的效果观察

我们对32例复杂创面患者应用负压封闭引流技术（VSD）治疗, 效果良好,报告如下.     

负压封闭引流技术治疗四肢创伤复杂创面的疗效观察

目的总结负压封闭引流技术治疗四肢创伤复杂创面的效果。方法将68例四肢创伤复杂创面患者按治疗方法的不同分成观察组和对照组2组。每组34例。观察组给予负压封闭引流技术治疗,对照组常规换药治疗,对比2组平均创面面积和并发症发生情况。结果观察组平均创面面积(28.12 cm2)小于对照组(48.35 cm2),观察组的并发症发生率(11.76%)低于对照组(50.00%),2组比较,差异均有统计学意义(P0.05)。结论对四肢创伤复杂创面实施负压封闭引流术可减小创面面积,促进创面愈合,且并发症少,值得临床应用。     

手术室护理在行负压封闭引流技术治疗的Ⅱ度烧伤患者中的应用效果

分析对行负压封闭引流技术治疗的Ⅱ度烧伤患者开展手术室护理的效果。方法 选取2 0 22年1月-12月于贵州医科大学附属医院接受负压封闭引流技术治疗的60例Ⅱ度烧伤患者为研究对象,按照随机数字表法分为对照组和研究组,每组30例。对照组采用常规护理模式,研究组采用手术室护理模式,比较两组护理满意度、护理质量及疼痛情况。结果 研究组护理满意度为96.67%,高于对照组的73.33%（P＜0.05）;研究组护理态度、心理疏导、管理措施、操作水平评分均高于对照组（P ＜0.05）;研究组VAS评分低于对照组,疼痛持续时间短于对照组（P ＜0.05）。结论 相比于常规护理模式,手术室护理在行负压封闭引流技术治疗的Ⅱ度烧伤患者中的应用效果确切,可有效提升护理质量,有利于减轻患者疼痛,且患者对护理模式的满意度较高。     

大面积烧伤患者四肢创面的整体负压封闭引流效果观察

目的:探讨大面积烧伤患者四肢创面采用整体负压封闭引流治疗的临床疗效.方法:我院2014年8月-2016年10月收治的大面积烧伤患者中,选择双侧肢体创面烧伤深度相同的患者48例,深Ⅱ度创面浅削痂,Ⅲ度创面切痂植皮,同一患者双侧肢体创面处理方法相同,然后,一侧肢体创面采取整体封闭负压引流,作为观察组,对侧肢体常规纱布包扎,作为对照组.比较48例成活患者治疗后第4、7、10、14天两组间创面愈合率及创面愈合时间.结果:观察组治疗后第7、10、14天深Ⅱ度浅削痂创面和Ⅲ度切痂植皮创面的愈合率均明显高于对照组,创面愈合时间也明显短于对照组.结论:创面在早期切削痂治疗后应用整体负压封闭引流,可促进创面愈合时间,对降低病死率有重要意义.     

负压封闭引流治疗电烧伤创面的护理

目的:探讨负压封闭引流治疗电烧伤患者的护理.方法;对18例电烧伤患者的植皮区和供皮区创面应用负压封闭引流术治疗.结果:18例电烧伤患者11例植皮区创面行1次VSD治疗7天后直接上皮化愈合.7例供皮区创面术后8天除1例潮湿未愈合创面外其他均愈合,效果满意.结论:在进行负压封闭引流治疗的护理中注意保持引流装置的密闭性和调整适宜的负压、持续冲洗以充分引流,同时密切观察局部创面皮肤血运及引流的情况,做好心理干预和饮食护理是保持治疗效果的关键.     

负压封闭引流技术联合重组人表皮生长因子治疗糖尿病足溃疡效果分析

目的 探讨负压封闭引流技术(VSD)联合重组人表皮生长因子(rhEGF)治疗糖尿病足溃疡的临床效果。方法 回顾性分析2019-01—2021-02中国人民解放军联勤保障部队第九八八医院整形烧伤科收治的50例糖尿病足溃疡患者的临床资料,分为对照组和联合组,各25例。2组均给予常规清创处理及VSD。联合组联合rhEGF注射。比较2组患者的溃疡创面愈合时间、住院时间、住院费用及不良反应。评价2组的临床治疗效果。结果 联合组溃疡创面愈合时间和住院时间均短于对照组,住院费用少于对照组,治疗总有效率高于对照组,差异均有统计学意义(P<0.05)。治疗期间2组患者均未出现严重不良反应。结论 VSD联合rhEGF治疗糖尿病足溃疡,溃疡创面愈合快、患者住院时间短、住院费用低、治疗总有效率高,而且无不良反应。是安全、可行性的治疗方案。     

表皮生长因子对大鼠深Ⅱ度烧伤创面愈合的影响

目的　进一步观察重组人表皮生长因子 (rhEGF)对深Ⅱ度烧伤创面愈合的促进作用。方法　采用大鼠深Ⅱ度烫伤模型 (以下称烧伤 ) ,创面分别外用rhEGF、肝素加rhEGF及等渗盐水。比较不同方式处理创面后的愈合时间 ,测定创面愈合率、创面含水量、羟脯氨酸 (OHP)含量及Ⅰ /Ⅲ型胶原比例 ,进行细胞DNA周期分析和组织学检查。　结果　外用rhEGF可使烧伤创面愈合时间缩短 2d,增加创面OHP含量 (P <0.0 5),降低Ⅰ /Ⅲ型胶原比例 (P <0.0 5),促进肉芽组织形成 ,加速细胞DNA复制 (P <0.0 5 )。加用肝素后可使创面愈合时间进一步缩短 2d,促进肉芽组织生长。伤后第 7天用药各组间比较 ,差异无显著性意义 (P >0.0 5)。　结论　外用rhEGF能明显促进深Ⅱ度烧伤创面愈合 ,加用肝素后效果更加显著 ,但早期使用rhEGF效果不明显     

负压封闭引流治疗损伤感染创面的护理观察

<正>四肢皮肤缺损是临床常见的急性损伤之一,对污染较重和部分复合组织缺损的病例暂时无法Ⅰ期行皮瓣和植皮修复,可考虑为Ⅱ期手术治疗创造条件,我们于2009-04—2010-10对68例四肢皮肤缺损的创面应用负压封闭引流技术治疗,其术后取得良好疗效,现总结如下。     

负压封闭引流在烧伤创面中的应用进展

烧伤创面是导致患者出现全身感染甚至是死亡的重要原因之一,以往临床常采用生理盐水、 碘伏等方式进行清创,但在实际的治疗过程中,上述清创方法无法充分引流创面的分泌物,在一定程度上 提高了患者的疼痛程度,延长其创面愈合时间。负压封闭引流是近年来兴起的一种创面治疗方法,可以有 效清除患者创面的坏死组织和渗出物,减轻换药过程中患者的疼痛感,从而缩短其创面愈合时间,降低感 染风险。基于此,本文就负压封闭引流技术在烧伤创面中的应用效果作一综述,旨在为临床治疗提供相关 参考。     

负压封闭引流技术在手部烧伤治疗的应用

手是人类日常生活、工作、学习、运动等活动中最活跃、最外露的部位。除极易遭受各种外伤,还常遭受各种原因的烧伤,如火焰、热液、电、化学腐蚀液、辐射等烧伤,以及热和机械的复合伤如热压伤等。自德国Ulm大学附属创伤外科医院的Wim Fleischman医学博士首创负压封闭吸引技     

早期负压封闭引流治疗深Ⅱ度烧伤创面的临床疗效评价

目的 前瞻性评价早期VSD治疗深Ⅱ度烧伤创面的临床疗效,为其临床应用提供依据.方法 选择笔者单位2009年5月-2010年3月收治的双下肢烧伤后3 h内入院、总面积小于10%且各下肢深Ⅱ度面积大于1%TBSA的患者22例.依照部位对称、深度相同、面积相近等同体对照原则,将每例患者创面分为VSD治疗组(应用VSD治疗)与对照组(应用10 g/L磺胺嘧啶银霜换药).观察2组患者创面的水分蒸发量、肿胀程度、细菌定植情况、疼痛程度、愈合时间及愈合质量并进行比较分析.数据行t检验与秩和检验.结果 21例患者完成试验,均在伤后4 h内完成创面处理.VSD治疗组正常皮肤及覆盖敷料前创面的水分蒸发量与对照组相近(t值分别为1.310、-0.911,P值均大于0.05);创面覆盖敷料2 h后,敷料表面的水分蒸发量[(44.3±3.9)mL·h-1·m-2]明显少于对照组[(66.1±6.4)mL·h-1·m-2,t=-11.39,P<0.01].伤后3、7 d,VSD治疗组大腿周径较伤后5 h分别增加了(3.48±0.35)、(2.51±0.21)cm,明显小于对照组的(8.02±0.41)、(3.99±0.32)cm(t值分别为4.110、3.569,P值均小于0.01).2组创面入院时及伤后10 d细菌培养阳性率组间比较,差异均无统计学意义(Z值分别为-0.894、0.000,P值均大于0.05);2组伤后10 d细菌培养阳性率均较各组入院时显著降低(Z值分别为-3.220、-3.870,P值均小于0.01).VSD治疗组创面伤后10 d的pH值(7.12±0.06)呈现弱酸性,对照组(7.41±0.13)则为中性.VSD治疗组伤后1、3、7 d创面疼痛程度轻于对照组(t值分别为-16.132、-21.230、-16.453,P值均小于0.01).2组创面愈合时间比较,差异无统计学意义(t=1.186,P>0.05).伤后2、3个月VSD治疗组创面愈合质量评价为佳(100.00%、100.00%),明显优于对照组(19.05%、85.71%,Z值分别为-11.638、-3.870,P值均小于0.01).结论 早期VSD治疗不能使深Ⅱ度烧伤创面愈合时间提前,但能显著提高其愈合质量,是处理深Ⅱ度烧伤创面的有效方法之一,值得临床关注与进一步研究.     

早期负压封闭引流治疗深Ⅱ度烧伤创面的临床疗效评价

Objective To evaluate the clinical curative effect of applying vaccum sealing drainage (VSD) therapy in treating deep partial-thickness burn wound at the initial stage prospectively, and to provide the basis for its clinical application. Methods Twenty-two patients with about 10% TBSA burn of the lower limbs, and in which partial-thickness wound exceeded 1% TBSA in each limb, were admitted to our hospital within 3 hours after burn from May 2009 to March 2010. Wounds in each patient were divided into VSD treatment group (treated with VSD therapy) and control group (treated with 10 g/L silver sulfadia-zine cream) based on the principles of symmetry of location, identical deepness, and similarity in size etc. The amount of water evaporation, the swelling intensity, the status of bacterial colonization, the degree of pain, the healing time, and the quality of healing of wounds in 2 groups were observed and compared. Data were processed with t test and rank-sum test. Results The observation was completed in 21 patients. All of the wounds were treated within 4 hours post burn (PBH). The amount of water evaporation of the normal skin and burn wounds before dressing coverage in VSD treatment group was respectively close to that in control group (with t value respectively 1.310, - 0. 911, P values all above 0.05) ; the amount of water evaporation on the surface of dressing in VSD treatment group [(44. 3 ±3.9) mL·h-1·m-2] was less than that in control group [(66.1 ±6.4) mL · h-1· m-2, t = -11.39, P <0.01]. In VSD treatment group, the circumference of proximal thigh increased (3.48 ±0.35) and (2.51 ±0.21) cm on post burn day (PBD) 3 , 7 as compared with that on PBH 5 , which was respectively smaller than that [(8.02 ± 0.41) , (3. 99 ± 0. 32) cm] in control group (with t value respectively 4. 110, 3. 569, P values all below 0. 01). Positive bacteria' culture rate on PBD 10 of each group was respectively lower than that at admission (with Z value respectively -3.220, -3.870, P values all below 0. 01) , and there was no significant statistical difference between 2 groups at admission or on PBD 10 (with Z value respectively - 0. 894, 0.000, P values all above 0.05). The wound surface in VSD treatment group was weak acidic (pH value 7. 12 ±0.06) on PBD 10,and it was neutral (pH value 7.41 ±0. 13) in control group. The wound pain degree in control group on PBD 1,3,7 was respectively higher than that in VSD treatment group (with t value respectively - 16. 132, -21.230, -16.453, P values all below 0.01). There was no significant statistical difference between 2 groups in healing time of wounds (t =1. 186, P >0.05). The healing quality of wounds in VSD treatment group (100. 00% , 100. 00%) 2 or 3 months after burn was better than that in control group (19. 05% , 85. 71%) (with Z value respectively -11.638, -3. 870, P values all below 0.01). Conclusions Early application of VSD therapy cannot expedite the healing process of deep partial-thickness burn wounds, but it can improve the healing quality. It is one of the effective methods to deal with deep partial-thickness burn wounds, which is worthy of clinical attention and further research.     

早期负压封闭引流治疗深Ⅱ度烧伤创面的临床疗效评价

Objective To evaluate the clinical curative effect of applying vaccum sealing drainage (VSD) therapy in treating deep partial-thickness burn wound at the initial stage prospectively, and to provide the basis for its clinical application. Methods Twenty-two patients with about 10% TBSA burn of the lower limbs, and in which partial-thickness wound exceeded 1% TBSA in each limb, were admitted to our hospital within 3 hours after burn from May 2009 to March 2010. Wounds in each patient were divided into VSD treatment group (treated with VSD therapy) and control group (treated with 10 g/L silver sulfadia-zine cream) based on the principles of symmetry of location, identical deepness, and similarity in size etc. The amount of water evaporation, the swelling intensity, the status of bacterial colonization, the degree of pain, the healing time, and the quality of healing of wounds in 2 groups were observed and compared. Data were processed with t test and rank-sum test. Results The observation was completed in 21 patients. All of the wounds were treated within 4 hours post burn (PBH). The amount of water evaporation of the normal skin and burn wounds before dressing coverage in VSD treatment group was respectively close to that in control group (with t value respectively 1.310, - 0. 911, P values all above 0.05) ; the amount of water evaporation on the surface of dressing in VSD treatment group [(44. 3 ±3.9) mL·h-1·m-2] was less than that in control group [(66.1 ±6.4) mL · h-1· m-2, t = -11.39, P <0.01]. In VSD treatment group, the circumference of proximal thigh increased (3.48 ±0.35) and (2.51 ±0.21) cm on post burn day (PBD) 3 , 7 as compared with that on PBH 5 , which was respectively smaller than that [(8.02 ± 0.41) , (3. 99 ± 0. 32) cm] in control group (with t value respectively 4. 110, 3. 569, P values all below 0. 01). Positive bacteria' culture rate on PBD 10 of each group was respectively lower than that at admission (with Z value respectively -3.220, -3.870, P values all below 0. 01) , and there was no significant statistical difference between 2 groups at admission or on PBD 10 (with Z value respectively - 0. 894, 0.000, P values all above 0.05). The wound surface in VSD treatment group was weak acidic (pH value 7. 12 ±0.06) on PBD 10,and it was neutral (pH value 7.41 ±0. 13) in control group. The wound pain degree in control group on PBD 1,3,7 was respectively higher than that in VSD treatment group (with t value respectively - 16. 132, -21.230, -16.453, P values all below 0.01). There was no significant statistical difference between 2 groups in healing time of wounds (t =1. 186, P >0.05). The healing quality of wounds in VSD treatment group (100. 00% , 100. 00%) 2 or 3 months after burn was better than that in control group (19. 05% , 85. 71%) (with Z value respectively -11.638, -3. 870, P values all below 0.01). Conclusions Early application of VSD therapy cannot expedite the healing process of deep partial-thickness burn wounds, but it can improve the healing quality. It is one of the effective methods to deal with deep partial-thickness burn wounds, which is worthy of clinical attention and further research.     

一期负压封闭引流结合二期植皮修复深度烧伤创面疗效探讨

目的:探讨一期负压封闭引流(Vacuum sealing drainage,VSD)结合二期植皮术对深度烧伤患者的治疗效果.方法:选取笔者医院2019年1月-2020年3月收治的深度烧伤患者66例,将所有患者采用随机数字表法分为对照组与观察组,对照组(n=32)采用一期传统换药治疗联合二期植皮治疗,观察组(n=34)采...     

负压封闭引流技术在烧伤科常见难治性创面治疗中的应用

负压封闭引流（vacuum sealing drainage,VSD）是一种治疗急、慢性创伤创面和（或）创腔的新技术,于1992年由德国ULM大学创伤外科Fleisehmann博士首创[1]。2008年10月至2009年10月我们采用封闭负压引流技术结合常规治疗手段治疗烧伤科常见难治性创面,疗效良好,现报道如下。     

负压封闭引流在感染创面的局部应用

目的:评估负压封闭引流术(VSD)在感染创面局部应用的效果.方法:挑选18名创面感染患者,平均年龄(45±10)岁,其中11名男性,7名女性,感染创面部位:手部8例,小腿5例,臀部3例,骶部2例,创面使用100～125mmHg负压持续吸引2天,然后间歇吸引,平均负压吸引时间为(9±2)天,测量VSD治疗前后创面大小,随访平均时间为(11±6)个月.结果:创面平均吸引出100±50ml液体,组织水肿及创面引流得到解决,创面清洁干燥,其中15例患者通过运用抗生素及负压吸引术,创面已达到临床愈合,细菌培养阴性,通过负压治疗创面大小从(28±9)cm2减少至(12±8)cm2(P<0.05),只有6例需要进一步外科干预达到闭合创面,2例患者使用负压吸引后感觉疼痛.结论:与传统治疗方法相比,除了VSD本身对创面快速愈合的优点外,还提供了一个快速、舒适的条件.     

皮肤美容护理在烧伤患者负压封闭引流治疗期间的应用效果

目的 探究在烧伤患者负压封闭引流治疗期间应用皮肤美容护理的效果。方法 选取我院2019年 1月-2023年10月收治的40例烧伤患者为研究对象,采用随机数字表法分为对照组和观察组,各20例。患者 均接受行负压封闭引流治疗,对照组采用基础护理,观察组采用皮肤美容护理,比较两组创面瘢痕情况、 心理感受、美学修复效果、并发症发生情况及护理满意度。结果 观察组柔软度、色泽、厚度、血管分布 评分均低于对照组（P ＜0.05）;观察组情绪受损、社会交往、自感缺陷、体貌关注、体貌认知、体貌改 变、体象障碍诱因及客观评价评分均低于对照组（P ＜0.05）;观察组美学修复总有效率为100.00%,高于 对照组的80.00%（P ＜0.05）;观察组并发症发生率为0,低于对照组的25.00%（P ＜0.05）;观察组护理满 意度为95.00%,高于对照组的70.00%（P ＜0.05）。结论 皮肤美容护理在烧伤患者负压封闭引流治疗期间 的应用效果确切,可减轻创面瘢痕,改善患者的不良情绪,有利于提升美学修复效果及护理满意度,减少 并发症发生风险。