组织工程与重建外科杂志

组织工程与重建外科杂志 ›› 2025, Vol. 21 ›› Issue (5): 479-.

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削痂植皮术联合负压封闭引流、纳米银医用抗菌敷料治疗深度烧伤的临床效果

  

  • 出版日期:2025-10-13 发布日期:2025-10-30

Clinical effects of tangential excision and skin grafting combined with vacuum sealing drainage and nano-silver medical antibacterial dressing in the treatment of patients with deep burns

  • Online:2025-10-13 Published:2025-10-30

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摘要：

目的 观察削痂植皮术联合负压封闭引流（VSD）、纳米银医用抗菌敷料治疗深度烧伤的临床效果。方法 选择2021年10月至2023年10月收治的106例深度烧伤患者，按随机数字表法分为两组，对照组53例行削痂植皮术联合VSD，研究组 53例行削痂植皮术联合 VSD、纳米银医用抗菌敷料治疗。比较两组的愈合情况、恢复指标、致痛因子、炎性指标、血管内皮生长因子（VEGF）、基质金属蛋白酶-9（MMP-9）、感染指标、并发症和抗生素使用情况。结果 研究组的愈合情况优于对照组（P<0.05）。研究组的创面愈合时间、住院时间短于对照组（P<0.05）。治疗后，研究组的5-羟
色胺、前列腺素E2、C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）、MMP-9、白细胞计数、中性粒细胞比例、降钙素原、肝素结合蛋白低于对照组（P<0.05），且均低于治疗前（P<0.05）。治疗后，研究组的 VEGF、血小板数量、血钙高于对照组（P<0.05），且均高于治疗前（P<0.05）。研究组的感染发生率低于对照组（P<0.05），瘢痕增生发生率、皮片移位发生率、创面积血积液发生率较对照组差异无统计学意义（P>0.05）。研究组抗生素使用率低于对照组P<0.05）；研究组抗生素使用时间较对照组短（P<0.05）。结论 削痂植皮术联合VSD、纳米银医用抗菌敷料治疗深度烧伤，可促进创面愈合，缩短住院时间，调节致痛因子、炎性指标、VEGF、MMP-9、感染指标，减少感染，降低抗生素使用率，以及缩短抗生素使用时间。

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Abstract:

Objective To observe the clinical effects of tangential excision and skin grafting combined with vacuum sealing drainage （VSD） and nano silver medical antibacterial dressing in treating deep burn patients. Methods From October 2021 to October 2023，106 deep burn patients were randomly divided into two groups using a random number table method. The control group consisted of 53 patients who underwent tangential excision and skin grafting combined with VSD， while the research group consisted of 53 patients who underwent tangential excision and skin grafting combined with VSD and nano silver medical antibacterial dressings. The two groups were compared in terms of condition of healing， recovery indicators， pain inducing factors， inflammatory indicators， vascular endothelial growth factor （VEGF） ， matrix metalloproteinase-9（MMP-9）， infection indicators， complications， and antibiotic usage. Results The healing of the research group was superior to that of the control group （P<0.05）. The wound healing time and hospital stay of the research group were shorter than those of the control group （P<0.05）. After treatment， the levels of 5-hydroxytryptamine， prostaglandin E2， C-reactive protein （CRP）， tumor necrosis factor- α（TNF- α）， MMP-9， white blood cell count， neutrophil ratio， procalcitonin， and heparin-binding protein in the research group were lower than those in the control group （P<0.05）， and all were lower than those before treatment （P<0.05）. After treatment， the VEGF， platelet count， and blood calcium in the research group were higher than those in the control group （P<0.05）， and all were higher than those before  treatment （P<0.05）. The infection rate of the research group was lower than that of the control group （P<0.05）， while the scar hyperplasia rate， the skin graft displacement rate， and the incidence of blood accumulation and fluid in the wound area were not statistically different from those of the control group （P<0.05）. The antibiotic usage rate of the research group was lower than that of the control group （P<0.05）； the antibiotic usage time of the research group was shorter than that of the control group （P<0.05）. Conclusion The combination of tangential excision and skin grafting with VSD and nano silver medical antibacterial dressings
can promote wound healing， shorten hospitalization time， regulate pain factors， inflammatory indicators， VEGF， MMP-9 and infection indicators， reduce infection， lower the antibiotic usage rate and shorten the antibiotic usage time.

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