重组人表皮生长因子凝胶联合黄连紫草膏治疗小面积深Ⅱ度烧伤创面的效果观察

目的:观察黄连紫草膏联合重组人表皮生长因子(rhEGF)凝胶局部应用治疗小面积深Ⅱ度烧伤创面的效果及对患者疼痛程度和创面细菌感染的影响.方法:选取河南省鹤壁市人民医院急诊科2018年7月—2020年11月收治的89例小面积深Ⅱ度烧伤患者作为研究对象,创面面积4％～11％TBSA.采用抽签法将患者分为两组.对照组44例给...     

重组人表皮生长因子与复合溶菌酶联合治疗儿童烧伤创面的效果研究

目的:观察重组人表皮生长因子与复合溶菌酶联合治疗儿童烧伤创面的临床效果,为临床治疗儿童烧伤提供一种新的治疗方法。方法:将80例儿童烧伤患者采用自身对照选择相同深度的两个创面随机分为治疗组与对照组进行研究治疗。治疗组给予重组人表皮生长因子与复合溶菌酶联合治疗;对照组给予硝酸银软膏治疗。临床观察创面愈合时间、创面炎症反应发生情况、创面细菌培养情况、过敏反应、创面愈合3个月后期随访有无色素沉着或脱失、瘢痕增生的情况。结果:治疗组比对照组创面愈合时间明显缩短,减少创面炎症反应及感染机会,治疗组明显优于对照组(P<0.05);患者未出现过敏反应和其它不良反应,后期随访瘢痕增生少。结论:重组人表皮生长因子与复合溶菌酶联合治疗儿童烧伤创面,明显缩短创面愈合时间,减轻创面炎症反应,疗效可靠。在今后儿童烧伤创面治疗中具有广阔的临床发展前景,适用于基层医院使用。     

胰岛素联合生长因子及湿性敷料处理难愈性烧伤残余创面的疗效研究

目的研究胰岛素联合生长因子及湿性敷料处理难愈性小面积深度烧伤残余创面的临床疗效。方法将40例深度烧伤后形成小面积难愈性残余创面168处的患者进行自身对照,在早期少量多次清创的基础上,采用胰岛素联合生长因子贝复剂湿敷后给予湿性敷料包扎(改进法,100处),与仅外喷生长因子后给予碘伏敷料湿敷包扎的常规法(68处)进行效果比较。结果两法换药疼痛评分、创面平均愈合时间、创面愈合率、不同时期创面分泌物细菌培养阳性率比较,差异有统计学意义(均P<0.01)。结论采用胰岛素联合生长因子及湿性敷料处理难愈性小面积深度烧伤残余创面,能提高创面愈合速度及愈合质量,减少患者痛苦,缩短住院时间。     

VSD技术联用表皮生长因子对深度烧伤创面愈合及炎症应激反应的影响

探讨VSD技术联用表皮生长因子对深度烧伤创面愈合及炎症应激反应的影响。方法 选取 2022年11月-2023年11月我院收治的深度烧伤患者62例,随机分为对照组和观察组,各31例。对照组应 用VSD技术与生理盐水冲洗治疗,观察组在对照组基础上应用表皮生长因子治疗,比较两组创面愈合 情况和炎症应激反应情况。结果 观察组创面愈合时间短于对照组,瘢痕生成数及感染数低于对照组 （P＜0.05）;观察组IL-1、TNF-α、E、NE、R水平低于对照组（P＜0.05）。结论 VSD技术结合表皮生 长因子能促进深度烧伤患者的创面愈合,提高创面愈合效果,减轻患者炎症应激反应。     

重组人表皮生长因子凝胶联合美宝湿润烧伤膏治疗热力Ⅱ度烧伤创面临床分析

目的探讨重组人表皮生长因子凝胶联合美宝湿润烧伤膏治疗Ⅱ度热力烧伤创面的方法和效果。方法随机将巩义市人民医院2014-07—2017-07间收治的128例Ⅱ度热力烧伤患者分为2组,各64例。2组均全身给予营养支持及辅助治疗。治疗组采用人表皮生长因子凝胶联合美宝湿润烧伤膏处理创面,对照组采用磺胺嘧啶锌软膏处理创面。观察2组的用药不良反应、创面愈合时间及愈合后创面的外观。结果对照组治疗期间发生药疹1例(1.56%),经对症处理后缓解;治疗组未发生不良反应。2组差异无统计学意义(P0.05)。治疗组烧伤创面愈合时间及愈合后创面外观均优于对照组,差异有统计学意义(P0.05)。结论重组人表皮生长因子凝胶联合美宝湿润烧伤膏治疗Ⅱ度热力烧伤创面,不良反应少,可促进创面良好愈合,应用效果满意。     

银离子藻酸盐敷料在儿童四肢深II度烧伤创面中的应用效果观察

目的:探讨藻酸盐银离子敷料治疗儿童深II度烧伤创面中临床效果.方法:选取2015年7月—2016年5月我院烧伤整形科收治的四肢深II度烧伤患儿共60例,随机分为观察组和对照组.在创面清创后,观察组外用藻酸盐银离子敷料覆盖,无菌纱布包扎;对照组采用银锌霜皮肤黏膜抗菌剂涂抹,无菌纱布包扎.两组均根据创面渗出情况换药.比较两组患儿的换药次数、入院第7天的发热率、创面愈合率及愈合时间.结果:与对照组相比,观察组换药次数(8.63±2.37)次,明显少于对照组(14.70±2.30)次,差异有统计学意义(P<0.05).观察组治疗第7天患儿发热率为6.67%(2例),明显低于对照组23.33%(7例),差异有统计学意义(P<0.05);观察组治疗第7、11、15和19天创面愈合率明显高于对照组,差异有统计学意义(P<0.05);观察组创面愈合时间为(20.70±2.30)d,住院时间为(21.33±3.67)d,均较对照组[(27.63±3.63)d和(28.30±3.30)d]缩短,差异具有统计学意义(P<0.05).结论:应用银离子藻酸盐敷料治疗儿童四肢深II度烧伤创面能减少换药次数,加速创面愈合,减少患者痛苦,值得推广和应用.     

3种不同药物治疗浅Ⅱ度烧伤感染创面效果观察

目的筛选最佳浅Ⅱ度烧伤感染创面换药配方.方法将120例浅Ⅱ度烧伤感染创面病人随机分为A、B、C 3组各40例.A组采用紫花烧伤膏、紫草油加庆大霉素联合配方换药;B组用庆大霉素纱条湿敷;C组将紫花烧伤膏直接涂于创面.结果A组疗效明显优于B组(P＜0.05),与C组比较差异无显著性意义;换药,更换敷料时病人的疼痛感A、C两组优于B组(均P＜0.01);伤口换药次数及愈合时间A组明显少于B、C组(P＜0.05,P＜0.01).结论选用A组药物配方治疗浅Ⅱ度烧伤感染创面既可减少换药次数,减轻病人的疼痛,又可明显缩短伤口愈合时间,有助于烧伤感染创面的恢复,具有临床应用及推广价值.     

龙珠软膏换药治疗痔瘘术后120例临床研究

目的 将龙珠软膏和湿润烧伤膏用于痔瘘术后换药，对比两者对创面换药的临床疗效。方法 120例用龙珠软膏换药，将药膏涂抹在适当大小的无菌纱条上后贴覆于创面；80例用湿润烧伤膏换药，其用法同龙珠软膏。两组患者术后静脉滴注抗生素3～7天。结果 龙珠软膏组创面平均愈合时间最长19．8天，最短9．5天；湿润烧伤膏组创面平均愈合时间最长23．8天，最短13．8天。龙珠软膏组比湿润烧伤膏组创面平均愈合时间缩短4天左右，且无明显不良反应。结论 痔瘘术后创面采用龙珠软膏换药比湿润烧伤膏换药时间短且愈合快。     

湿润烧伤膏联合重组人表皮生长因子凝胶在Ⅱ度烧伤中的临床应用

目的探讨湿润烧伤膏(MEBO)联合重组人表皮生长因子凝胶治疗烧伤的效果。方法对152例不同面积的Ⅱ度烧伤创面应用湿润烧伤膏联合重组人表皮生长因子凝胶并配合全身治疗,回顾性分析患者的临床资料。结果本组88例浅Ⅱ度烧伤患者创面愈合时间(6.52±1.28)d,64例深Ⅱ度烧伤创面愈合时间(13.38±3.06)d。102例(71.05%)无瘢痕形成,24例(15.79%)轻度色素沉着,10例(6.58%)色素缺失,18例(11.84%)遗留轻中度瘢痕增生。结论湿润烧伤膏联合重组人表皮生长因子凝胶有效缩短烧伤创面愈合时间,减少烧伤瘢痕形成程度。     

生肌玉红膏联合百克瑞纱布创面敷料对肛周脓肿术后创口恢复的疗效观察

目的:观察肛周脓肿术后采用生肌玉红膏联合百克瑞纱布创面敷料换药对创口恢复的效果.方法:将60例肛周脓肿手术患者按随机数字法分为治疗组和对照组,各30例.对照组术后使用康复新液纱条换药,治疗组术后使用生肌玉红膏联合百克瑞纱布创面敷料换药.观察比较2组肉芽生长、创面水肿、创面渗出、愈合时间及治疗效果.结果:治疗组痊愈率为8...     

Children's post-burn scars in Mongolia

This study aimed to identify some risk factors for post-burn scarring in children aged 0–18 years. One hundred and eighty two participants were involved in this cohort study. Under the age of 18 who were admitted to the Department of Burn Reconstructive Surgery with a diagnosis of upper and lower extremity burns were followed for 6 months. A total of 182 participants (62.1% male, and 37.9% female participants) enrolled in this study. Age ranged from 1 to 17 and the average age was 3.95 ± 3.35. The degree of burn and the anatomical location of the burn had a statistically significant effect on the development of hypertrophic scars. The length of the patient's hospitalisation days and the area of ​​the burn were statistically correlated with wound healing (P = 000, P = .074). For example, the average length of hospitalisation days was 8 ± 5 days in the hypertrophic scars group of patients, and in the group with normal scars, average bed days were 6 ± 3 days (P = .000). Grade IIIb burns increased the risk of hypertrophic scar development by 4.9 times and grade IV burns increased it by 2.5 times. In addition, when the area of burns was 11% or more, the risk of hypertrophic scar development was increased by 58.8%. In the case of wound swab infection, the risk of hypertrophic scar development was 12.4% higher (B = 1.124, 95 EI = 0.55; 2.28, P = .748). Participants' age, burn area and degree of burn are statistically significant risk factors for post-burn scarring in children aged 0–18 years.     

Photographic assessment of burn wounds: A simple strategy in a resource-poor setting

Objective

To validate the use of photographic burn wound assessment in evaluation of burn size and wound characteristics.

Methods

Feasibility study of agreement between methods of measurement of burn size and characteristics, in patients admitted to the burn unit at Kamuzu Central Hospital (KCH), Malawi, over two months in 2011. Burn wounds were photographed and assessed clinically, concurrently, by an experienced clinician. Photographs reviewed by two blinded burn clinicians after 4–6 weeks. Correlation between clinical assessment and photographic evaluation was calculated using kappa score and Pearson's correlation coefficient.

Results

Thirty-nine patients were included in evaluation of TBSA, and fifty wounds assessed for their characteristics. Pearson's correlation coefficient for agreement of TBSA between clinical exam and photograph review by expert#1, and #2, was 0.96, 0.93 (p < 0.001), respectively. Pearson's correlation coefficients comparing expert#1 and #2 to the gold standard were: proportion of full-thickness burn (0.88 and 0.81, p < 0.001), and epithelialized superficial burn (0.89 and 0.55, p < 0.001). Kappa scores were significant for wound evolution (expert#1 0.57, expert#2 0.64, p < 0.001), and prognosis (expert#1 0.80, expert#2 0.80, p < 0.001).

Conclusions

Burn assessment with digital photography is a valid and affordable alternative to direct clinical exam, alleviating access issues to burn care in developing countries.     

多个手指掌侧深度烧伤创面的整形修复

目的：探讨修复多个手指掌侧深度烧伤创面的理想方法。方法：1999年1月～2003年12月，采用腹部联合薄皮瓣延迟修复的方法，治疗2个以上手指掌侧深度烧伤患者7例l9指。结果：移植皮瓣和皮片均100％成活，伤口Ⅰ期愈合。除1指因深浅屈肌腱均损伤，屈曲功能障碍外，其余18指功能完全恢复，手指外形良好，基本达到了美学要求。结论：腹部联合薄皮瓣延迟修复术是修复多个手指掌侧深度烧伤创面的良好方法。     

A general overview of burn care

The majority of burn victims do not need to be treated in a burn centre. Adequate care can be given by non specialised medical personnel, provided that proper guidelines are followed. The article outlines and reviews these guidelines.     

The infection risk of plastic wrap as an acute burns dressing

Background

Domestic plastic wrap has been recommended as an appropriate acute burn wound dressing in the Emergency Management of Severe Burns course. There remain limited studies reporting the risk of infection associated with this dressing.

Aim

To determine the potential infection risk of domestic plastic wrap used to treat acute burns wounds by assessment for the presence of clinically significant micro-organisms.

Methods

Ten plastic wrap samples were collected from a roll that had been opened for several months on the burns ward at our institution. Plastic wrap was imprinted directly onto horse-blood agar plates. The plates were incubated for 72 h in aerobic conditions with 5% CO₂.

Results

We found no significant growth on any agar plate after incubation. A sufficient amount of plastic wrap was sampled to be confident that areas up to 12 cm × 12 cm from the centre of the plastic sheet were aerobically sterile.

Conclusions

Our data suggest that the potential for plastic wrap to act as a fomite when used as an acute burn wound dressing is extremely low.     

Effects of granulocyte colony-stimulating factor on bacterial translocation due to burn wound sepsis

The presence of certain defects in both cellular and humoral immunity after thermal injury has been established. Likewise, the translocation of enteric bacteria to the mesenteric lymph nodes and to distant organs has also been observed following serious thermal injury. The effects of granulocyte colony-stimulating factor (G-CSF) on bacterial translocation, the small bowel mucosa, and cecal bacterial content were investigated in a rat model of burn wound sepsis in which albino Wistar rats were scalded over 30% of their bodies, after which the lesions were infected by 1×10⁸ colony-forming units (cfu)Pseudomonas aeruginosa. The control group was treated with 5% dextrose solution subcutaneously starting 2 days preburn, while the treatment group received 100μg/kg human G-CSF subcutaneously. On the 4th day post burn all animals were killed to examine the bowel and culture of the mesenteric lymph nodes (MLN), livers, and spleens. No significant differences were observed between the groups regarding the cecal bacterial content and small bowel; however, a difference was seen in the ratio of translocation in the MLN liver and spleen and quantitative MLN cultures. Based on these findings, G-CSF was thus found to be significantly effective in reducing bacterial translocation due to burn wound sepsis.