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急诊磨痂术联合生物敷料A对深Ⅱ度烧伤创面微循环及预防脓毒症的临床效果

Clinical Effect of Emergency Dermabrasion Combined with Biological Dressing A on Wound Microcirculation and Preventing Sepsis in Deep Degree-II Burns.

作者信息

Shao Huawei, Luo Ru, You Chuangang, Li Qiong, Mao Shulei

机构信息

Department of Burns & Wound Care Centre, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang 310030, China.

Department of Pathology, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang 310030, China.

出版信息

Emerg Med Int. 2022 Jul 14;2022:4730905. doi: 10.1155/2022/4730905. eCollection 2022.

Abstract

OBJECTIVE

The aim of this study is to explore the clinical effect of emergency dermabrasion combined with biological dressing A on wound microcirculation and preventing sepsis in deep degree-II burns.

METHODS

A total of 90 patients with deep degree-II burns admitted to the hospital were retrospectively enrolled between January 2020 and January 2022. According to different treatment methods, they were divided into the control group (42 cases, biological dressing A) and the observation group (48 cases, emergency dermabrasion combined with biological dressing A). The clinical curative effect in both groups was observed. The wound repair rate and wound healing quality, and changes in levels of wound microcirculation-related indexes (serum epidermal growth factor (EGF), wound blood flow, and partial pressure of transcutaneous oxygen) and inflammatory cytokines (C-reactive protein (CPR), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT)) before treatment, at 3d and 7d after treatment were compared between the two groups. The incidence of wound infection and sepsis in both groups was recorded.

RESULTS

The wound healing time in the observation group was significantly shorter than that in the control group, and wound healing quality in the observation group was better than that in the control group ( < 0.05). At 3 d and 7d after treatment, the levels of serum EGF, wound blood flow and partial pressure of transcutaneous oxygen in both groups were all increased ( < 0.05), which were higher in the observation group than those in the control group ( < 0.05). The levels of CRP, IL-6, ESR, and PCT in both groups were all decreased ( < 0.05), which were lower in the observation group than those in the control group ( < 0.05). There was no significant difference in incidence of sepsis between observation group and control group (4.17% (2/48) vs. 7.14% (3/42)) ( = 0.539).

CONCLUSION

Emergency dermabrasion combined with biological dressing A can effectively improve wound microcirculation in patients with deep degree-II burns, promote wound healing, shorten wound healing time, improve wound healing quality, effectively control inflammatory response, and prevent sepsis.

摘要

目的

本研究旨在探讨急诊磨痂术联合生物敷料A对深Ⅱ度烧伤创面微循环及预防脓毒症的临床效果。

方法

回顾性纳入2020年1月至2022年1月期间收治的90例深Ⅱ度烧伤患者。根据治疗方法不同,将其分为对照组(42例,采用生物敷料A)和观察组(48例,采用急诊磨痂术联合生物敷料A)。观察两组的临床疗效。比较两组治疗前、治疗后3 d和7 d时创面修复率、创面愈合质量,以及创面微循环相关指标(血清表皮生长因子(EGF)、创面血流量、经皮氧分压)和炎症细胞因子(C反应蛋白(CPR)、白细胞介素-6(IL-6)、红细胞沉降率(ESR)、降钙素原(PCT))水平的变化。记录两组创面感染和脓毒症的发生率。

结果

观察组创面愈合时间明显短于对照组,且观察组创面愈合质量优于对照组(P<0.05)。治疗后3 d和7 d时,两组血清EGF、创面血流量和经皮氧分压水平均升高(P<0.05),且观察组高于对照组(P<0.05)。两组CRP、IL-6、ESR和PCT水平均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组与对照组脓毒症发生率比较,差异无统计学意义(4.17%(2/48)比7.14%(3/42))(P=0.539)。

结论

急诊磨痂术联合生物敷料A可有效改善深Ⅱ度烧伤患者创面微循环,促进创面愈合,缩短创面愈合时间,提高创面愈合质量,有效控制炎症反应,预防脓毒症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9c5/9303507/cb3419cc445b/EMI2022-4730905.001.jpg

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