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我们在会阴烧伤方面的经验和临床发现:对患者预后的影响——一项为期3年的回顾性研究。

Our Experience and Clinical Findings in Perineal Burns: Implications for Patient Prognosis-A 3 Year Retrospective Study.

作者信息

Iordache Matei, Bordeanu-Diaconescu Eliza-Maria, Grosu-Bularda Andreea, Andrei Mihaela-Cristina, Frunza Adrian, Grama Sabina, Costache Raducu, Neagu Tiberiu-Paul, Lascar Ioan, Hariga Cristian-Sorin

机构信息

Department of Plastic Surgery and Reconstructive Microsurgery, "Carol Davila" University of Medicine and Pharmacy Bucharest, 010825 Bucharest, Romania.

Burn Centre, Emergency Clinical Hospital of Bucharest, 014461 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2024 Dec 5;60(12):2009. doi: 10.3390/medicina60122009.

Abstract

Burn injury represents a very important public health problem that affects all age groups. Of all burns, of particular interest is that of the perineum. Despite the importance of the subject, unfortunately, the medical literature on this anatomical region is sparse. With this study we aim to analyze the characteristics of burns affecting the perineal area, the physiopathologic implications of this injury, the influence of patient prognosis, possible complications and therapeutic guidelines. This study is formed by a retrospective analysis of cases that were admitted over a period spanning 3 years with a total of 258 burned patients. After inclusion criteria, we selected 49 patients who had perineal burns and compared this group to a non-perineal burns lot of 198 patients (11 were excluded). We studied their characteristics and the demographical aspects that we deemed most important to their condition: age, sex, burn percentage of total body surface area (TBSA), the percentage of third-degree lesions, comorbidities, and associated infections, inhalation injuries and we calculated the significant scores such as the Abbreviated Burn Severity Index score (ABSI). The patients in our study mostly had severe extensive burns (64.9% mean TBSA) which were also underlined by the mean ABSI of 10.88 ± 2.46 thus having a poor prognosis considering their age, the percentage of burned area, the presence of third-degree burns and inhalation injuries. In our study, perineal burns were usually associated with burns of adjacent regions abdominal wall burns comprising 51% and thigh burns comprising 97.9% of the associated injuries. This relationship both explains their presence in mostly severe cases with higher TBSA and also underlines the issues that derive from the burns of the perineum and their several complications which lead to an unbalance of the patients. The treatment of perineal burns still remains much debated in the literature when considering their indications and can become rather complex in the sequelae setting. The issue of burns remains one of the most important subjects in plastic surgery. Being a region hard to treat but with a big influence on patient evolution and survival chances prevention remains a key factor.

摘要

烧伤是一个影响所有年龄组的非常重要的公共卫生问题。在所有烧伤中,会阴部烧伤尤其值得关注。尽管该主题很重要,但不幸的是,关于这个解剖区域的医学文献却很稀少。通过本研究,我们旨在分析会阴部烧伤的特征、这种损伤的生理病理影响、对患者预后的影响、可能的并发症以及治疗指南。本研究通过对3年内收治的258例烧伤患者的病例进行回顾性分析组成。根据纳入标准,我们选择了49例会阴部烧伤患者,并将该组与198例非会阴部烧伤患者(排除11例)进行比较。我们研究了他们的特征以及我们认为对其病情最重要的人口统计学方面:年龄、性别、烧伤占总体表面积(TBSA)的百分比、三度损伤的百分比、合并症、相关感染、吸入性损伤,并计算了诸如简化烧伤严重程度指数评分(ABSI)等重要评分。我们研究中的患者大多有严重的广泛烧伤(平均TBSA为64.9%),平均ABSI为10.88±2.46也突出了这一点,考虑到他们的年龄、烧伤面积百分比、三度烧伤和吸入性损伤的存在,预后较差。在我们的研究中,会阴部烧伤通常与相邻区域的烧伤相关,腹壁烧伤占相关损伤的51%,大腿烧伤占97.9%。这种关系既解释了它们在大多数TBSA较高的严重病例中的存在,也突出了会阴部烧伤及其多种并发症所产生的问题,这些问题导致患者失衡。当考虑会阴部烧伤的治疗指征时,其治疗在文献中仍存在很多争议,并且在后遗症情况下可能会变得相当复杂。烧伤问题仍然是整形外科中最重要的主题之一。作为一个难以治疗但对患者病情发展和生存机会有很大影响的区域,预防仍然是一个关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0dd/11727808/abef6080f42f/medicina-60-02009-g001.jpg

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