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用激光清创术治疗芥子气烧伤。

The treatment of sulphur mustard burns with laser debridement.

作者信息

Evison D, Brown R F R, Rice P

机构信息

Biomedical Sciences Department, Dstl Porton Down, Salisbury, Wiltshire SP4 0JQ, United Kingdom.

出版信息

J Plast Reconstr Aesthet Surg. 2006;59(10):1087-93. doi: 10.1016/j.bjps.2006.02.010. Epub 2006 Jul 7.

Abstract

The chemical warfare agent, sulphur mustard (SM), is a potent blistering agent in man. Skin exposure can produce partial-thickness burns which take up to three months to heal. The aim of this study was to investigate the use of early laser ablation as a means of accelerating this exceptionally slow rate of healing. Four circular partial-thickness SM burns were induced on the dorsum of nine large white pigs (under general anaesthesia). At 72 h post-exposure, three burns per animal were ablated with a single pass of an UltraPulse 5000C CO(2) laser, at a fluence of 5-6 J cm(-2). All the burns were dressed with silver sulphadiazine and a semi-occlusive dressing. At one, two and three weeks post-surgery three animals were culled and all lesions excised for histological analysis. Burn depth was confirmed and measurements of the radii of regenerative epithelium were performed allowing the area of the zone of re-epithelialisation in each lesion to be calculated. Laser-treated lesions showed a significant increase (350%) in healing rates compared to controls (p<0.005). At two weeks, the laser-treated sites were 95% healed in comparison with control sites (28% healed). These data suggest that laser ablation may be effective in the treatment of partial-thickness SM-induced skin injury.

摘要

化学战剂硫芥(SM)对人类是一种强力的起泡剂。皮肤接触可导致深二度烧伤,愈合时间长达三个月。本研究的目的是探讨早期激光消融作为加速这种异常缓慢愈合速度的一种方法的应用。在九只大白猪的背部(全身麻醉下)造成四个圆形深二度硫芥烧伤。暴露后72小时,每只动物的三个烧伤部位用UltraPulse 5000C二氧化碳激光单次照射消融,能量密度为5 - 6 J/cm²。所有烧伤部位均用磺胺嘧啶银和半封闭敷料包扎。术后1周、2周和3周,分别处死三只动物,切除所有损伤组织进行组织学分析。确认烧伤深度,并测量再生上皮的半径,从而计算每个损伤部位的再上皮化区域面积。与对照组相比,激光治疗的损伤部位愈合率显著提高(350%)(p<0.005)。两周时,激光治疗部位的愈合率为95%,而对照部位为28%。这些数据表明,激光消融可能对治疗深二度硫芥所致皮肤损伤有效。

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