削痂植皮术联合负压封闭引流技术在深度烧伤创面修复中的应用

目的观察削痂植皮术后联合应用负压封闭引流技术（vacuum sealing drainage,VSD）对深度烧伤创面的治疗效果。方法对四川省人民医院烧伤科2008-08/2010-08收治的54例深度烧伤病例（随机分成2组,其中28例（实验组）采用削痂植皮术后联合VSD技术封闭创面,26例（对照组）采用削痂植皮术后普通敷料加压包扎封闭创面,对两组术后的平均换药次数、创面平均愈合时间、植皮成活率情况、平均住院时间进行统计学分析,对此两种方法进行评价。结果实验组与对照组比较,在平均换药次数、创面平均愈合时间、植皮成活率、平均住院时间的对比,差异有统计学意义（P〈0.05）。结论深度烧伤创面采用削痂植皮术联合负压封闭引流技术与传统削痂植皮后加压包扎相比,减少了平均换药次数,缩短创面平均愈合时间及平均住院时间,提高了植皮成活率,取得显著疗效。该手术方法操作简单,术后护理方便,是一种较理想的植皮后的固定方法,有利于创面的愈合,值得临床推广应用。

Vacuum Sealing Drainage and Tangential Excision With Dermatoplasty in Treatment of Depth Burn

Objective To evaluate the clinical outcome of vacuum sealing drainage（VSD）after tangential excision with dermatoplasty in the treatment of the deep burn wound.Methods Fifty-four patients with deep burns from Sichuan Provincial People′s Hospital during August,2008 to August,2010 were randomly devided into two groups,28 patients（the experimental group）received dermatoplasty and VSD,26 patients（the control group） received compression bandage after dermatoplasty.The average number of dressing changes,the average time of wound healing,the average survival rate of skin graft and the average hospitalization time in two groups were analyzed statistically to compare the therapeutic effect of these 2 methods.Results experimental group compared with the control group,the average number of dressing changes was fewer,the average time of wound healing was shorter,the average survival rate of skin graft was higher,the average hospitalization time was shorter,with the differences statistically significant（P0.05）.Conclusion Vacuum sealing drainage（VSD）after tangential excision with dermatoplasty in the treatment of the deep burns compared with compression bandage after dermatoplasty,the frequency of dressing changes is reduced,the average time of wound healing and the average hospitalization time are shortened,with the average frequecy of antibiotic after skin graft reduced,and the average survival rate of skin graft improved,achived significant effect.Therefore,this method is easy to be manipulated and convenient to be nursed after operation,and is an ideal choice for the fixed treatment after dermatoplasty for patients with burn wound,is worthy of clinical application.