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目的评估烧伤再生医疗技术(moist exposed burn therapy/moist exposed burn ointment,MEBT/MEBO)治疗儿童Ⅱ~Ⅲ度烧伤创面的临床疗效和安全性。方法 2015年9月—2016年8月埃及亚历山大大学总医院烧伤科收治的20例5岁以下Ⅱ度和/或Ⅲ度烧伤患儿,均于入院后在全身综合治疗的基础上接受MEBT/MEBO治疗局部创面,其中Ⅱ度烧伤创面每天换药3次,直至创面愈合;Ⅲ度烧伤创面每天换药3次,待创面肉芽组织生长良好后,予以植皮术封闭创面。观察肉芽组织形成时间、创面愈合时间、瘢痕增生情况及药物不良反应,并检测治疗过程中创面细菌感染情况。结果肉芽组织的形成时间为10~19 d;浅Ⅱ度烧伤创面愈合时间为6~7 d,愈后皮肤弹性正常,无明显瘢痕增生及色素沉着;深Ⅱ度烧伤创面愈合时间为14~19 d,除2例患儿部分愈后皮肤留有非增生性软瘢痕外,其余患儿愈后皮肤均未见明显瘢痕增生;Ⅲ度烧伤创面均进行了皮肤移植,愈合情况良好;治疗3周后患儿创面感染率由入院时的70%下降至0;治疗过程中所有患儿均未出现药物不良反应;随访6个月,所有四肢烧伤患儿均无四肢功能障碍及畸形。结论MEBT/MEBO治疗儿童Ⅱ~Ⅲ度烧伤,可有效促进Ⅱ度烧伤创面的生理性再生愈合,恢复皮肤的正常组织结构及功能,避免植皮;可显著促进Ⅲ度烧伤创面焦痂的液化脱离以及肉芽组织的早期生长,为皮肤移植做好准备,提高移植皮片的成活率;可有效抑制细菌生长,防治创面感染;操作简便、安全可靠,可有效降低过敏反应及副反应的发生率。
Objective To evaluate the clinical efficacy and safety of moist exposed burn therapy / moist exposed burn ointment (MEBT / MEBO) in the treatment of Ⅱ ~ Ⅲ degree burn wounds in children. Methods From September 2015 to August 2016, 20 children with grade Ⅱ and / or Ⅲ degree burn under the age of 5 admitted to the Department of Burns, General Hospital of Alexandria University in Egypt received MEBT / MEBO The treatment of partial wounds, of which Ⅱ degree burn wound dressing 3 times a day until the wound healing; Ⅲ degree burns wounds dressing 3 times a day until the wound granulation tissue growth well, the skin grafting closed wounds. The granulation tissue formation time, wound healing time, scar hyperplasia and adverse drug reactions were observed. The bacterial infection in the wound during the treatment was also observed. Results The formation time of granulation tissue was 10-19 days. The wound healing time of superficial Ⅱ degree burns was 6-7 days, and the skin elasticity was normal without any scar hyperplasia and hyperpigmentation. The healing time of deep second degree burn wounds was 14-19 d, except for 2 cases of children with non-hypertrophic scar left after the skin, the rest of the skin after the child had no significant scar hyperplasia; Ⅲ degree burn wounds were skin grafts, healing in good condition; for 3 weeks The incidence of wound infection in infants decreased from 70% at admission to 0. No adverse reactions occurred in all children during the course of treatment. All patients with limb burns had no dysfunction and deformity after 6 months of follow-up. Conclusion MEBT / MEBO treatment of children with Ⅱ ~ Ⅲ degree burn can effectively promote the physiological regeneration of wound healing, restore the normal skin structure and function of the skin, to avoid skin grafting; can significantly promote third-degree burn wound eschar escaping and The early growth of granulation tissue for skin graft to prepare to improve the survival rate of transplanted skin graft; can effectively inhibit bacterial growth, prevention and treatment of wound infection; easy to operate, safe and reliable, can effectively reduce the incidence of allergic reactions and side effects.