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目的:观察小儿深Ⅱ度烧伤创面早期电动磨痂后结合不同种敷料覆盖的治疗效果。方法:将2010年1月—2012年1月收治的60例四肢和躯干热液烫伤患儿随机分为凡士林油纱组、生物敷料组和负压封闭引流(VSD)组,每组20例。各组患儿在磨痂后,根据分组的不同,分别应用凡士林油纱、异种脱细胞真皮基质或VSID覆盖创面。术后观察创面愈合时间、愈合质量、换药次数、治疗费用。结果:生物敷料组、VSD组的创面愈合时间分别为(16.3±1.9)d和(16.9±1.8)d,明显短于凡士林纱布组[(19.2±2.5)d,P<0.05];生物敷料组、VSD组反映瘢痕增生程度的温哥华评分分别为(4,5±0.7)分和(4.1±0.8)分,明显低于凡士林油纱组[(8.6±1.2)分,P<0.01];VSD组的换药次数[(3.0±0.5)次]明显低于凡士林油纱组[(6.9±0.7)次,P<0.05]和生物敷料组[(7.2±0.8)次,P<0.01];凡士林油纱组的住院费用[(6 560.34±1 230.00)元],明显低于生物敷料组[(12 028.24±1 380.00)元,P<0.01]和VSID组[(14 125.40±1 560.00)元,P<0.01]。结论:早期磨痂应用异种生物敷料和VSD覆盖较普通油纱覆盖能明显促进小儿深Ⅱ度烧伤创面愈合,缩短住院时间,显著提高创面愈合质量,减少换药次数,减轻患儿痛苦,但住院费用较高,临床上应根据患儿具体情况,灵活选择磨痂后创面覆盖物。
OBJECTIVE: To observe the therapeutic effect of different kinds of dressings after electric scab in pediatric deep second degree burn wounds. Methods: Sixty children with hydrothermal burns on limbs and torso from January 2010 to January 2012 were randomly divided into vaseline gauze group, biological dressing group and VSD group, 20 cases in each group. Each group of children after grinding scab, according to the different groups, respectively, Vaseline Yarn, acellular acellular dermal matrix or VSID wound coverage. Postoperative wound healing time, healing quality, dressing change, treatment costs. Results: The wound healing time in the dressing group and the VSD group was (16.3 ± 1.9) days and (16.9 ± 1.8) days, significantly shorter than that in the Vaseline gauze group [(19.2 ± 2.5) days, P <0.05] , And the Vancouver score of VSD group (4 ± 0.7) and (4.1 ± 0.8) was significantly lower than that of vaseline (8.6 ± 1.2), P <0.01; (6.9 ± 0.7) times, P <0.05], and the group of dressings [(7.2 ± 0.8) times, P <0.01]; Vaseline (6 560.34 ± 1 230.00) yuan for the yarn group was significantly lower than that of the biological dressing group [(12 028.24 ± 1 380.00) yuan, P <0.01] and the VSID group [(14 125.40 ± 1 560.00) yuan, P <0.01]. CONCLUSION: The application of heterosexual dressing and VSD to the coverage of common oil gauze can significantly promote wound healing in children with deep second degree burn, shorten the length of hospital stay, significantly improve the quality of wound healing, reduce the number of dressing changes and relieve the pain of children, but hospitalization Higher cost, clinical conditions should be based on specific children, flexible choice after grinding scab wound cover.