摘要/Abstract
摘要： 目的 ·探求异型聚氨酯泡沫敷料在大面积烧伤患者头皮供皮区的应用价值。方法 ·选取 2017年 10月—2018年 10月在上海交通大学医学院附属瑞金医院烧伤整形科住院的既往健康的大面积烧伤成年患者，将入选患者历次植皮手术后的头皮供皮区按处理方式的不同分为对照组和研究组。对照组采用单层干纱布修剪敷贴，研究组采用异型聚氨酯泡沫敷料，比较 2组创面愈合时间、相邻 2次植皮手术间隔时间、患者术后疼痛视觉模拟评分（ visual analogue scale，VAS）、医护人员工作量等指标。结果 ·研究组的头皮供皮区平均愈合时间为（ 6.77±0.10）d，对照组为（ 9.73±0.17）d；研究组相邻 2次手术间隔时间为（ 9.33±0.16）d，对照组为（11.90±0.22）d，2组差异均有统计学意义（均 P0.000）。研究组患者术后各个时相点 VAS均显著低于对照组（均 P0.000）。使用异型聚氨酯泡沫敷料可以明显减少患者的翻身床治疗时间，且无需烤灯治疗，减少医护工作人员的工作量。结论 ·异型聚氨酯泡沫敷料的使用可能可以提高大面积烧伤患者头皮供皮区的愈合速度，缩短再次植皮手术的时间间隔，进而可使大面积烧伤患者创面尽早得到覆盖；同时减轻患者术后的疼痛，减少术后护理的工作量。
关键词: 大面积烧伤, 聚氨酯泡沫敷料, 头皮, 愈合, 疼痛
Abstract:
Objective · To evaluate shaped polyurethane foam dressing applied on scalp donor sites in the patients with extensive burn. Methods · The extensively burned adult patients without chronic diseases before injury, who were hospitalized in the Department of Burns and Plastic Surgery, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine October, 2017 to October, 2018 were selected. Their scalps as skin donor sites during all past grafting surgeries were divided into two groupsdifferent treatments, i.e. control group and research group. The scalps in control group were coveredgauze clippedthe skulls. Those in research group were coveredshaped polyurethane foam dressing. Afterwards, the wound healing time for the scalps, the intervals between the two adjacent grafting operations, the post-operation pain assessedvisual analogue scale (VAS), and the workload of medical staffs were analyzed and compared between the two groups. Results · The mean time of wound healing for scalp donor sites in research group was (6.77±0.10) d, whereas it was (9.73±0.17) d in control group. For the intervals between the two contiguous operations, they were (9.33±0.16) d in research group and (11.90±0.22) d in control group, respectively. The differences in these two indexes between the two groups were statistically significant (P0.000). Also, the VAS scores were significantly lower in research group compared with those in control group at all the points after operations (P0.000). The application of shaped polyurethane foam dressing evidently reduced the treatment time for turning bed and had no need of lamp-aid treatment, so it reduced the workload for medical staffs. Conclusion · The application of shaped polyurethane foam dressing on extensively burned patients’ scalp may significantly accelerate its wound healing, shorten the intervals between two grafting operations, which will be beneficial in closing the wounds of these patients earlier eventually. Meanwhile, its application may also alleviate pains of the patients and reduce the burdens of post-operation nursing.
Key words: extensive burn, polyurethane foam dressing, scalp, wound healing, pain
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