烧伤后早期准确削痂治疗深Ⅱ度创面的临床研究

目的探讨烧伤后早期在深Ⅱ度创面削痂手术中使用电动取皮刀准确削痂，对创面进程和愈合质量的影响。方法选择62例深Ⅱ度烧伤患，随机分为二组，均在伤后72h内进行创面削痂手术。术中分别使用电动取皮刀和滚轴取皮刀削痂，观察术中削痂创面出血量、手术所需时间、创面愈合时间及残留肉芽创面的发生事。结果早期对深Ⅱ度创面削痂能降低局部炎症反应。与滚轴取皮刀削痂相比较，用电动取皮刀削痂可降低残留创面的发生率22．6％，缩短病程3．5d。结论电动取皮刀削痂可尽量保存残存的皮肤附件，避免使用滚轴取皮刀削痴过程中经常出现的削痂创面边缘锯齿样切口，也可以避免因术经验、技术的不足所导致的削痴过浅或过深的问题，促进创面愈合和缩短病程，是一种简单易行的削痂方法。

Clinical Researches on the Wound Healing of Deep-Ⅱ Burn after Cutting Crust by Motor Dermatome

Objective To observe the effects on deep II skin wound healing after early burns to cut crust by motor dermatome.Methods Sixty two burned patients with deep II skin wound were randomly divided into 2 groups after early burns. One group (31 patients) served as the experimental group to cut crust by motor dermatome,and the other group (31 patients) as the control group by rolling axis blade. The amount of blood after cutting crust, time of operation, time of wound healing and incidence rate of remained granulation wound were observed.Results Using motor dermatome could lower local inflammation reaction,the incidence rate of remained granulation wound could lower to 22.6% and course could be shortened to 3.5 days as compared with rolling axis blade. Conclusions There are some advantages of cut crust by motor dermatome as compared with rolling axis blade, such as more skin appendage, regular borderline of wound, simple operation technique and shorter course et al. Key words cutting crust; motor dermatome ;wound healing