CAJ | 학술논문

目的：探讨封闭负压引流技术在大面积烧伤患者后期感染难愈创面治疗方面的效果。方法：回顾性分析2011年9月至2014年8月我院收治的后期创面感染难愈的大面积烧伤患者17例，扩创+刃厚自体邮票皮移植或常规换药治疗1周后效果不佳，采用扩创植皮联合封闭负压引流技术修复创面，治疗第3天行创面分泌物细菌培养，观察皮片成活率，治疗第6天停用封闭负压引流治疗，观察并记录创面愈合率，此后进行常规换药至创面全部愈合，观察治疗期间的换药痛感，并记录创面完全愈合的时间。结果：扩创植皮联合封闭负压引流治疗后3 d，创面分泌物培养4例耐甲氧西林金黄色葡萄球菌阳性，皮片的成活率平均为83.9%；治疗后6 d，创面愈合率平均为85.7%。治疗期间换药时患者疼痛程度较前明显减轻。17例患者创面均于入院后36～49 d完全愈合。结论：封闭负压引流治疗是大面积烧伤后期合并感染难愈合创面的有效治疗方法，可明显提高移植皮片成活率，促进创面愈合。
목적：탐토봉폐부압인류기술재대면적소상환자후기감염난유창면치료방면적효과。방법：회고성분석2011년9월지2014년8월아원수치적후기창면감염난유적대면적소상환자17례，확창+인후자체유표피이식혹상규환약치료1주후효과불가，채용확창식피연합봉폐부압인류기술수복창면，치료제3천행창면분비물세균배양，관찰피편성활솔，치료제6천정용봉폐부압인류치료，관찰병기록창면유합솔，차후진행상규환약지창면전부유합，관찰치료기간적환약통감，병기록창면완전유합적시간。결과：확창식피연합봉폐부압인류치료후3 d，창면분비물배양4례내갑양서림금황색포도구균양성，피편적성활솔평균위83.9%；치료후6 d，창면유합솔평균위85.7%。치료기간환약시환자동통정도교전명현감경。17례환자창면균우입원후36～49 d완전유합。결론：봉폐부압인류치료시대면적소상후기합병감염난유합창면적유효치료방법，가명현제고이식피편성활솔，촉진창면유합。
Objective: Study of the effect of vacuum sealing drainage in the treatment of infection wound healing at later stage of large area burn.Methods: A retrospective analysis of 17 patients with refractory infection wounds at later stage of large area burn from September 2011 to August 2014. Debridement + blade thickness from 1 week atfer treatment ineffective stamp body skin transplantation or conventional dressing, using debridement and skin gratfing combined with vacuum-assisted closure wound repair. Treatment of the ifrst three days the line wound secretions bacterial culture, the concept of survival Chapi sheet, 6 days of treatment disable VAC therapy, wound healing rate was observed and recorded. After which regular dressing to the wound healed, the dressing was observed during treatment pain, and the wound is completely healed record time.Results: 3 days of debridement and skin grafting combined with vacuum sealing drainage after treatment, 4 cases of wound secretion culture <br> of methicillin resistant staphylococcus aureuspositive, skin gratf survival rate was 83.9% in average; 6 days atfer treatment, the wound healing rate was 85.7%. During the treatment of patients with pain relief was signiifcantly reduced compared with the previous. A total of 17 patients were healed after 36~49 d.Conclusion: Vacuum assisted closure therapy is effective in treatment at large area burn wound infection; vacuum assisted closure therapy can signiifcantly improve the skin gratf survival rate, and promote wound healing.