Green M, Holloway G A, Heimbach D M
Harborview Medical Center, Seattle, WA.
J Burn Care Rehabil. 1988 Jan-Feb;9(1):57-62. doi: 10.1097/00004630-198801000-00014.
Because burns are dynamic wounds that can change in apparent depth during the first 72 hours, we asked whether measuring changes in cutaneous blood flow might help predict the ultimate fate of burns that were not obviously shallow or deep. A laser Doppler flowmeter was used to study cutaneous perfusion for at least 72 hours in partial-thickness wounds on patients with burns of less than 15% TBSA and in experimental wounds of similar size on rats. Clinical wounds that healed without grafting consistently showed elevated perfusion levels which increased further within 72 hours, whereas wounds eventually requiring grafting experienced lower perfusion levels with no obvious pattern of increase. Differences between average flow levels for healing and nonhealing burns were statistically significant throughout the study period. Perfusion levels in experimental wounds were stratified according to burn severity, with shallower wounds showing a pattern of increase similar to the clinical wounds.
由于烧伤是动态伤口，在最初72小时内其表观深度可能会发生变化，因此我们探讨了测量皮肤血流变化是否有助于预测那些既不明显表浅也不明显深部的烧伤的最终转归。使用激光多普勒血流仪对烧伤面积小于15%体表面积的患者的部分厚度伤口以及大鼠身上类似大小的实验性伤口进行至少72小时的皮肤灌注研究。无需植皮即可愈合的临床伤口持续显示灌注水平升高，且在72小时内进一步升高，而最终需要植皮的伤口灌注水平较低，且没有明显的升高模式。在整个研究期间，愈合和未愈合烧伤的平均血流水平差异具有统计学意义。实验性伤口的灌注水平根据烧伤严重程度进行分层，较浅的伤口显示出与临床伤口相似的升高模式。
