rhEGF凝胶在肌皮瓣修复深度电击烧伤创面中的应用

目的:探讨重组人表皮生长因子(rhEGF)凝胶在肌皮瓣修复深度电击烧伤创面中的应用效果。方法:选取2013年2月-2018年10月笔者医院收治的84例深度电击烧伤患者,随机分为对照组与观察组,各42例。对照组采取常规清创及肌皮瓣修复治疗,观察组另在清创后、植皮后给予rhEGF凝胶涂抹。对比清创后至肌皮瓣修复时间、二次清创率、修复术前创面感染发生情况,并比较术后肌皮瓣成活及创面愈合情况,另对比供区创面愈合时间及住院时间,且术后随访12个月,观察供区创面瘢痕形成情况。结果:观察组清创后至肌皮瓣修复时间明显短于对照组,二次清创率及修复术前创面感染发生率明显低于对照组,差异有统计学意义(P<0.05)。对照组与观察组术后肌皮瓣均完全成活(100.00%),其中创面一期愈合率分别为88.10%(37/42)、92.86%(39/42),其余经换药及引流后均创面愈合,且供区均愈合良好。观察组供区创面愈合时间及住院时间明显短于对照组,观察组术后6个月及12个月的供区创面瘢痕评分均明显低于对照组,差异有统计学意义(P<0.05)。结论:在肌皮瓣修复深度电击烧伤创面中应用rhEGF凝胶,可明显缩短清创至肌皮瓣修复时间,减少二次清创及术前创面感染的发生,术后创面愈合效果满意,并可加快供区创面愈合速度,缩短住院时间,可减少术后供区瘢痕形成。

Application Effect of rhEGF Gel in Perioperative Period of Myocutaneous Flap Repair for Deep Electric Burn Wounds

Objective To explore the application effect of recombinant human epidermal growth factor(rhEGF)gel in perioperative period of myocutaneous flap repair for deep electric burn wounds.Methods 84 patients with deep electric burn admitted to our hospital from February 2013 to October 2018 were selected,who were randomly divided into control group and observation group,with 42 cases in each group.The control group was treated with routine debridement and myocutaneous flap repair,while the observation group was given rhEGF gel smear in the perioperative period of myocutaneous flap repair.The time from debridement to myocutaneous flap repair,the secondary debridement rate and the incidence of wound infection before repair were compared,and the survival of myocutaneous flaps and wound healing after operation were compared,and the healing time of donor wounds and the hospitalization time were compared,then follow-up for 12 months after operation,and the scar formations in the donor site wound were also observed.Results The time from debridement to myocutaneous flap repair of the observation group was significantly shorter than that of the control group,and the secondary debridement rate and the incidence rate of wound infection before repair of the observation group were significantly lower than those of the control group,the difference were statistically significant(P<0.05).The myocutaneous flaps were complete survival(100.00%)in the control group and the observation group after operation,and the first-stage healing rate of the wounds of them was 88.10%(37/42)and 92.86%(39/42)respectively,and the other wounds were healed after dressing change and drainage,and the all donor site were healing well.The healing time of donor site wounds and the hospitalization time of the observation group were significantly shorter than those of the control group(P<0.05).The scar index of donor site wounds of the observation group at 6 months and 12 months after operation were significantly lower than those of the control group(P<0.05).Conclusion The application of rhEGF gel in the perioperative period of myocutaneous flap repair for deep electric burn wounds can significantly shorten the time from debridement to myocutaneous flap repair,reduce the incidence of secondary debridement and wound infection before repair operation,of which the wound healing effect after operation is satisfactory,and it can accelerate the wound healing speed of donor site,shorten the hospital stay and reduce the scar formation of donor site after operation.