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目的比较深Ⅱ度烧伤创面3种治疗方法的效果。方法选择对治疗方案知情同意的深Ⅱ度烧伤患者27例,根据患者意向分为封闭式负压引流(VSD)组、磺胺嘧啶银(SD-Ag)组、削痂组,每组9例。VSD组:维持负压20～60 kPa,持续7～10 d。SD-Ag组:每日外用SD-Ag。削痂组:伤后24 h内削痂并覆盖生物敷料。术后进行康复治疗,定期随访,评估疗效。结果创面愈合时间:VSD组(18.64±3.25)d,SD-Ag组(22.35±3.45)d,削痂组(24.67±3.38)d,VSD组明显短于SD-Ag组及削痂组(均P<0.05)。随访1年瘢痕评估:VSD组“-”例数显著多于SD-Ag组和削痂组(均P<0.01),“+”～“+++”总例数明显少于SD-Ag组和削痂组(均P<0.05)。结论 VSD方法可使创面高效引流,清除细菌,进行自溶性清创,操作简单。术后同时进行康复治疗,可最大限度地恢复外形和功能,无明显增生性瘢痕。
Objective To compare the effects of three treatments on deep second degree burn wounds. Methods Twenty-seven patients with deep second degree burn who were informed by the protocol were divided into three groups: closed negative pressure drainage (VSD) group, SD-Ag group and tangential excision group according to the patient’s intention. VSD group: maintain negative pressure 20 ~ 60 kPa, lasting 7 ~ 10 d. SD-Ag Group: Daily external SD-Ag. Chuck removal group: within 24 hours after injury cut scab and cover the biological dressing. Postoperative rehabilitation, regular follow-up, to assess the efficacy. Results The wound healing time was significantly shorter in the VSD group (18.64 ± 3.25) d, in the SD-Ag group (22.35 ± 3.45) d, and in the tangential excision group (24.67 ± 3.38) d P <0.05). One year follow-up scar evaluation: the number of “-” cases in the VSD group was significantly more than that in the SD-Ag group and the pared-off group (all P <0.01), and the total number of cases in the “+ ” ~ “+++” Less than the SD-Ag group and the group of torn scab (both P <0.05). Conclusion The VSD method can effectively drain wounds, remove bacteria and carry out autolysis debridement. The operation is simple. At the same time after rehabilitation treatment, to maximize the shape and function recovery, no obvious hypertrophic scar.