Wan Lei, Zhou Jin, Li Linjie
Lei Wan, Department of Critical Care Medicine, Huangshi Central Hospital, Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, Huangshi 435000, Hubei, P.R. China.
Jin Zhou, The Central Hospital of Xiaogan Emergency Surgery, Xiaogan 432100, Hubei, P.R. China.
Pak J Med Sci. 2022 Sep-Oct;38(7):1832-1837. doi: 10.12669/pjms.38.7.5522.
To investigate the effects of punctate skin grafting combined with or without irrigation on skin graft survival, redness and swelling score and pain in the treatment of large-area residual burn wounds.
A prospective study was conducted on 102 patients with large-area burns treated in Huangshi Central Hospital from May 2017 to May 2020. According to different treatment methods, they were divided into combination group (treated with punctate skin grafting combined with irrigation) and grafting group (mainly treated with punctate skin grafting). The positive rate of bacterial culture of wound secretions, pain score and redness and swelling score were analyzed and compared between the two groups. Additionally, linear logistic analysis of the influencing factors was carried out.
The positive rate of bacterial culture of wound secretions decreased to 29.4% in the combination group and 49.0% in the grafting group (p< 0.05). The skin graft survival rate of the combination group was (82.17 ± 7.44) %, which was higher than that of the grafting group (61.53 ± 7.46) %, the wound healing time was (14.56 ± 3.51) d, which was shorter than that of the grafting group (21.36 ± 4.69) d, and the pain score (3.26 ± 0.36) and redness and swelling score (1.16 ± 0.68) were lower than those of the grafting group (4.79± 0.46) and (2.56 ± 0.85), respectively (all p< 0.05). The wound healing time was positively correlated with pain score (r = 0.767, p< 0.05) and redness and swelling score (r = 0.672, p< 0.05), while negatively correlated with skin graft survival rate (r= -0.289, P<0.01), meeting linear equation y = -8.451 + 4.542a + 0.087b + 1.012c (a, pain score; b, skin graft survival rate; c, redness and swelling score).
Punctate skin grafting combined with irrigation in the treatment of large-area residual burn wounds presents great effects on skin graft survival, redness and swelling score and pain, and is worthy of clinical application and promotion.
探讨点状植皮联合或不联合冲洗对大面积残余烧伤创面植皮成活率、红肿评分及疼痛的影响。
对2017年5月至2020年5月在黄石市中心医院治疗的102例大面积烧伤患者进行前瞻性研究。根据不同治疗方法，将其分为联合组（采用点状植皮联合冲洗治疗）和植皮组（主要采用点状植皮治疗）。分析比较两组创面分泌物细菌培养阳性率、疼痛评分及红肿评分。此外，对影响因素进行线性逻辑分析。
联合组创面分泌物细菌培养阳性率降至29.4%，植皮组为49.0%（p<0.05）。联合组植皮成活率为（82.17±7.44）%，高于植皮组（61.53±7.46）%；创面愈合时间为（14.56±3.51）d，短于植皮组（21.36±4.69）d；疼痛评分（3.26±0.36）及红肿评分（1.16±0.68）均低于植皮组（4.79±0.46）和（2.56±0.85），差异均有统计学意义（均p<0.05）。创面愈合时间与疼痛评分（r = 0.767，p<0.05）及红肿评分（r = 0.672，p<0.05）呈正相关，与植皮成活率呈负相关（r = -0.289，P<0.01），符合线性方程y = -8.451 + 4.542a + 0.087b + 1.012c（a为疼痛评分；b为植皮成活率；c为红肿评分）。
点状植皮联合冲洗治疗大面积残余烧伤创面，在植皮成活率、红肿评分及疼痛方面效果显著，值得临床应用推广。
