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体外冲击波,一种治疗严重烧伤的新非手术方法。

Extracorporeal shock waves, a new non-surgical method to treat severe burns.

机构信息

Department of Plastic, Aesthetic and Reconstructive Surgery and Burn Center Vall d'Hebron University Hospital, Autonomous University of Barcelona, Passeig de la Vall d'Hebron 119-129, 08025 Barcelona, Spain.

出版信息

Burns. 2010 Sep;36(6):844-9. doi: 10.1016/j.burns.2009.11.012. Epub 2010 Jan 13.

Abstract

UNLABELLED

Extracorporeal shock wave treatment (ESWT) increases perfusion in ischaemic tissues, stimulates growth factors, decreases inflammation and accelerates wound healing. It is a safe technique classically used in urology and orthopaedic surgery with success, but there is still limited literature regarding its use in the management of burns.

PURPOSE

The aim of this study is to analyse the effect of ESWT on deep partial/full thickness burns in patients attended at our emergency burn unit.

MATERIALS AND METHODS

We performed two ESWT sessions in 15 patients with <5% TBSA (total body surface area) deep partial/full thickness burns, on the third and fifth day after injury; prior to each session, we used laser Doppler imaging (LDI).

RESULTS

Of all treated burns, 80% healed uneventfully prior to 3 weeks; as many as 15% required surgical debridement and grafting and 5% developed hypertrophic scarring. After one ESW session, burns had a significant increase in perfusion, objectivated by the LDI images.

CONCLUSIONS

Extracorporeal shock wave therapy emerges as a new non-invasive, feasible, safe and cost-effective method in deep partial/full thickness burns. It may decrease the need of surgery and therefore the morbidity of the patient. There is a strong need for more studies to establish the optimal timing and dosage of treatment.

摘要

目的:本研究旨在分析体外冲击波治疗(ESWT)对我院急诊烧伤科收治的 <5% TBSA(总体表烧伤面积)深度部分/全层烧伤患者的疗效。

材料和方法:我们对 15 例深度部分/全层烧伤患者(烧伤面积 <5% TBSA)进行了两次 ESWT 治疗,分别在损伤后第 3 天和第 5 天进行;在每次治疗前,我们使用激光多普勒成像(LDI)进行评估。

结果:所有接受治疗的烧伤中,80%在 3 周前愈合良好,15%需要手术清创和植皮,5%出现增生性瘢痕。单次 ESWT 治疗后,烧伤的灌注显著增加,LDI 图像可客观显示。

结论:ESWT 是一种新的非侵入性、可行、安全且具有成本效益的治疗深度部分/全层烧伤的方法。它可能减少手术的需求,从而降低患者的发病率。需要进一步的研究来确定治疗的最佳时间和剂量。

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