大面积烧伤植皮后残余创面应用浸浴疗法与护理

目的:用浸浴的方法治疗与护理大面积烧伤患者植皮后的残余创面.方法:选择80例烧伤患者,烧伤面积在TBSA20％～90％之间,其中浸浴组(治疗组,40例)和常规换药组(对照组,40例),两组差异无统计学意义(P＞0.05).浸浴组采用1:10000的洗必泰浸浴液浸浴治疗,后常规换药.根据病情,每周两次或隔日浸浴,同时加强护理,行创面分泌物细菌培养并记录愈合情况;对照组只给予常规换药.结果:与对照组相比治疗组平均愈合时间缩短(P＜0.05),治疗1周后创面菌株明显减少(P＜0.05).结论:用浸浴的方法治疗与护理植皮后的残余创面能减轻病人的痛苦、控制感染、缩短病程.     

Meek植皮技术在烧伤肉芽创面的临床应用

目的探讨治疗大面积深度烧伤病人因自体皮源缺乏，错过早期植皮机会时，形成肉芽创面，故在肉芽创面上行Meek植皮的可行性。方法本组16例病人，平均烧伤面积为65％TBSA，II度烧伤面积45％TBSA，伤后20～35天及肉芽创面上行Meek植皮。结果30个部位中26个部位效果良好，只有4个部位失败，有效率为86．7％。结论治疗大面积深度烧伤患者错过早期切痂机会时．在肉芽创面上行Meek植皮是可行的。     

大面积烧伤患者四肢创面的整体负压封闭引流效果观察

目的:探讨大面积烧伤患者四肢创面采用整体负压封闭引流治疗的临床疗效.方法:我院2014年8月-2016年10月收治的大面积烧伤患者中,选择双侧肢体创面烧伤深度相同的患者48例,深Ⅱ度创面浅削痂,Ⅲ度创面切痂植皮,同一患者双侧肢体创面处理方法相同,然后,一侧肢体创面采取整体封闭负压引流,作为观察组,对侧肢体常规纱布包扎,作为对照组.比较48例成活患者治疗后第4、7、10、14天两组间创面愈合率及创面愈合时间.结果:观察组治疗后第7、10、14天深Ⅱ度浅削痂创面和Ⅲ度切痂植皮创面的愈合率均明显高于对照组,创面愈合时间也明显短于对照组.结论:创面在早期切削痂治疗后应用整体负压封闭引流,可促进创面愈合时间,对降低病死率有重要意义.     

深Ⅱ度烧伤创面伤后24小时内削痂的临床观察

目的　探讨深Ⅱ度烧伤患者伤后 2 4h内创面行削痂术的安全性和临床疗效。　方法12例有削痂手术指征并在伤后 2 4h内行削痂术的深Ⅱ度烧伤患者为A组 ;14例削痂条件相似并按常规在伤后 4～ 6d行削痂术的深Ⅱ度烧伤患者为B组。比较两组休克期补液量、休克征象发生率、回吸收期的生命体征、尿量及愈合时间。　结果　两组患者在休克期补液量、休克征象发生率方面差异均无显著性意义 (P >0 .0 5 ) ;A组休克期尿量明显增多 ,回吸收期的体温、心率与B组明显不同(P <0 .0 5～ 0 .0 1) ;A组创面平均愈合时间较B组短 (P <0 .0 1)。　结论　深Ⅱ度烧伤创面于伤后2 4h内削痂是安全的 ,并能缩短创面愈合时间。     

创面切削痂植皮手术对深度烧伤创面病人瘢痕外观及愈合时间的影响

目的分析创面切削痂植皮手术对深度烧伤创面病人瘢痕外观及愈合时间的影响。方法烧伤病人100例,采用随机信封法分为观察组及对照组,每组各50例;观察组采用创面切削痂植皮手术治疗,对照组采用常规方法治疗;比较两组病人创面愈合时间和创面皮肤血运恢复时间,并观察两组病人植皮成活情况、疼痛程度及外观和活动功能。结果观察组病人创面愈合时间及创面皮肤血运恢复时间均明显短于对照组,差异有统计学意义(P0.05);观察组病人皮片成活率高于对照组(P0.05),观察组感染、瘢痕形成、疼痛感及痉挛发生率低于对照组(P0.05);观察组病人外观及功能优良率高于对照组(P0.05)。结论对烧伤病人采用创面切削痂植皮手术治疗可改善病人深度烧伤创面瘢痕外观,加速创面愈合。     

中小面积深Ⅱ度烧伤创面分次手术植皮与一次手术植皮的比较

目的探讨中小面积深度烧伤创面分次手术植皮与一次手术植皮的临床效果及愈后结果。方法选择78例TBSA≤30%深度肢体烧伤病人,随机分成两组。A组43例,应用分次手术治疗深度烧伤创面,即第1次削痂手术后,创面覆盖异体皮或人工水凝胶敷料,3~7d后再次行创面扩创+自体皮覆盖术;B组35例,削痂后创面立即覆盖自体皮;观察比较两种方法在皮片成活率、创面感染发生率、皮下血肿发生率、瘢痕增生发生率的差异,以及病人在住院天数及住院费用上的差异。结果分次手术组(A组)皮片成活率高于一次手术组(B组)(P<0.01),创面感染发生率A组与B组差异无统计学意义(P>0.05),皮下血肿发生率、瘢痕增生发生率A组明显低于B组(P<0.01)。A组病人住院天数比B组病人平均长(5.3±1.2)d,住院费用也有少量增加。结论在中小面积深度烧伤分次手术可以有效的提高皮片成活率,减少皮片下血肿发生率和瘢痕增生发生率;但是病人病程延长,费用增加。一次手术植皮可以缩短病人住院时间,降低住院费用,如果手术中病人创面间生态较少,也可以一次手术植皮。     

悬浮床不同温度对烧伤患儿创面愈合的影响

目的 探讨悬浮床治疗患儿烧伤创面的适宜温度,以提高疗效,减少患儿疼痛程度及并发症.方法 将入睡悬浮床治疗的60例烧伤惠儿随机分为观察组与对照组各30例,两组入院清创后暴露创面即入睡悬浮床,观察组将悬浮床的温度设置为28℃,对照组设置为32℃.比较两组患儿的创面疼痛、创面干痂形成时间、痂皮厚度、脱痂时间、创面愈合时间、创面细茵培养阳性率及脱水症发生率.结果 两组患儿创面疼痛、痂皮厚度、脱痂时间、创面愈合时间比较,差异有统计学意义(P<0.05,P<0.01).结论 悬浮床温度设定为28℃治疗患儿烧伤创面,能减轻疼痛,避免创面损伤,促进创面愈合.     

复合溶葡萄球菌酶消毒剂治疗烧伤后期创面感染的临床观察

目的 观察复合溶葡萄球菌酶消毒剂在治疗烧伤后期创面感染的疗效和安全性,评价其临床应用价值.方法 对入选的60例烧伤后期创面感染患者,采用随机分组,在常规治疗的基础上,治疗组入院后创面应用复合溶葡萄球菌酶消毒剂(上海高科生物工程有限公司生产)溶液清创并湿敷,1次/d;对照组以庆大霉素+0.9%氯化钠注射液纱布湿敷,1次/d.2组创面清洁后40例行清创植皮,治疗组及对照组各20例.检测创面菌群变化,比较两组累计细菌清除率、创面愈合时间及愈合率.结果 治疗组用药后3、6、9d累计细菌清除率为45.8%、73.9%、89.5%,较对照组13.8%、27.6%、57.4%明硅增高(P＜0.01).创面愈合时间治疗组(12±5)d,较对照组(16±4)d明显缩短(P＜0.01).创丽愈合率治疗组明显高于对照组(P＜0.01).用药后均未发现不良反应.结论 烧伤后期创面感染应用复合溶葡萄球菌酶消毒剂治疗,有效地控制了感染、提高了植皮成活率、缩短了创面愈合时间,安全有效.     

深Ⅱ度烧伤创面伤后24小时内削痂的安全性和促进愈合的临床观察

目的探讨深Ⅱ度烧伤创面伤后24h内削痂的安全性和临床疗效.方法12例有削痂手术指征并在伤后24h内实施削痂术的深Ⅱ度烧伤患者为实验组,并选14例条件相似并按常规在伤后4～6d行削痂术的深Ⅱ度烧伤患者作为对照组.结果两组病人在休克期补液量、休克期休克征象发生上无显著差别,而实验组创面愈合天数为(19.08±5.31)d,较对照组(29.36±7.03)d明显减少(P＜0.01),同时实验组的休克期尿量明显增多,回吸收期的体温、心率较对照组明显改善.结论深Ⅱ度烧伤创面伤后24h内削痂是安全的,并能缩短创面平均愈合天数.     

影响Meek植皮术治疗大面积深度烧伤疗效的多因素分析

目的探讨大面积深度烧伤患者Meek植皮术的预后影响因素。方法选择2014年1月至2018年1月间于我院诊治的96例大面积深度烧伤患者,根据Meek植皮术后30d愈合情况分为早期愈合组(30 d,62例)和延迟愈合组(≥30 d,34例)。比较两组患者的临床资料、手术相关指标和术后并发症发生情况。应用多因素Cox回归模型分析影响创面愈合能力的危险因素。结果两组患者的年龄、性别比、吸入性损伤比例、烧伤面积(%TBSA)、真皮深部组织/皮肤全层(deep dermal/full thickness,DD/FT)比例及烧伤原因等临床资料无统计学差异(P 0. 05),早期愈合组的烧伤面积明显小于延迟愈合组(P 0. 05)。早期愈合组的创面所需的供皮面积、手术时间和住院时间明显少于延迟愈合组,移植皮片成活率明显高于延迟愈合组(P 0. 05)。早期愈合组和延迟愈合组术后30 d内的并发症总发生率分别为11. 29%和35. 29%,早期愈合组术后并发症的总发生率明显低于延迟愈合组(P 0. 05)。多因素Cox回归分析显示,烧伤面积(%TBSA)和移植皮片成活率是影响创面愈合能力的独立影响因素,其中,烧伤总面积/TBSA(HR=0. 282,P=0. 009)是影响创面完全愈合的独立危险因素,移植皮片成活率(HR=2. 279,P=0. 028)是创面完全愈合的保护因素。结论大面积深度烧伤患者Meek植皮后的预后情况与烧伤面积及移植皮片成活率有关;对大面积烧伤病人,提高Meek植皮术后皮片成活值得重视。     

几种深Ⅱ度烧伤创面处理方法的回顾及改善创面微循环的初步实验研究

目的回顾性分析几种深Ⅱ度烧伤创面的修复方法,探讨改善创面微循环对创面愈合的意义. 方法 (1)对于笔者单位烧伤患者的深Ⅱ度创面,应用削痂疗法治疗614例、磨痂疗法治疗32例、清创后异体皮覆盖86例、外用磺胺嘧啶银后创面暴露1 836例、外用中药京万红烫伤膏包扎治疗408例.统计、分析各种疗法的治疗效果.(2)制作大鼠深Ⅱ度烫伤模型.伤后5 min内分别由其尾静脉注入等渗盐水(对照组,10只)、巴曲酶(治疗组,10只),创面均外用磺胺嘧啶银.测定两组大鼠伤前及伤后0.5-72.0 h的创面皮肤血流灌注单位,计算其伤后14、18 d的创面愈合率、收缩率及创面愈合时间.用组织学方法观察两组大鼠创面愈合后的皮肤毛囊数. 结果 (1)削痂疗法术后2-3周创面愈合,其中烧伤总面积50%～79%TBSA的患者治愈率94.8%,总面积80%～98%TBSA者治愈率93.4%.磨痂疗法磨痂+异体皮覆盖术后(13.8±2.1)d创面愈合,无瘢痕形成.清创后异体皮覆盖其中82例患者术后(18.0±2.3)d创面愈合.外用磺胺嘧啶银后暴露其中1 658例患者用药后(26.0±3.2)d痂下愈合.外用京万红烫伤膏后包扎患者多有细菌感染,其中下肢创面愈合时间为(26.0±2.8)d.(2)治疗组大鼠伤后2.0-72.0 h创面局部血流灌注单位均明显高于对照组(P<0.01).伤后14、18 d,治疗组创面愈合率明显高于对照组(P<0.01),但两组创面收缩率接近(P>0.05).治疗组创面愈合时间短于对照组(P<0.01).伤后30 d,对照组大鼠真皮层中残存少量毛囊,数量明显少于治疗组(P<0.01). 结论深Ⅱ度烧伤后早期采用削痂、磨痂或清创后覆盖异体皮的方法处理创面,可减轻感染、缩短疗程、提高治愈率和愈合质量.使用巴曲酶可改善深Ⅱ度烧伤创面微循环,加快愈合速度.     

First aid is associated with improved outcomes in large body surface area burns

BackgroundAnimal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h after burn reduces healing time and scarring. We have previously demonstrated the benefits of first aid in minor burn injuries with respect to a reduction in wound depth, faster healing, and decreased skin grafting utilisation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes in large body surface area burn injuries (≥20%).MethodsData was prospectively collected for patients with ≥20% TBSA burns from 2004– 2018. Multivariate regression analysis was used to determine the association of adequate first aid with 8 outcomes – mortality, total length of stay, total body surface area (TBSA), percentage/proportion of TBSA that was full thickness [PFTI], TBSA grafted, number of re-grafting sessions, intensive care admission, and intensive care length of stay. Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury.Findings390 patients were identified. Adequate first aid was received in 35.6% (139) of patients. There was a trend towards a reduction in mortality (OR 0.37; 95% CI 0.12–1.13; P = 0.08). Patients who received adequate first aid had a statistically significant 9.8% reduction in TBSA (95% CI −13.6% to −6.1%; P < 0.0001) as well as a 12% lower PTFI compared to patients who received inadequate first aid (95% CI −19% to −4%; P < 0.01). Whilst there was no significant effect of adequate first aid on the TBSA grafted (P = 0.37), adequate first aid was associated with a significantly less number of re-grafting sessions (95% CI −-0.29 to −0.08; P < 0.001).InterpretationAdequate first aid with 20 min of running water is associated with improved outcomes in large burn injuries. Significant benefits are seen in a reduction in TBSA, proportion of the burn wound that is full thickness, as well as decreased re-grafting. This has significant patient and health system benefits and adds to the body of evidence supporting 20 min of cooling in burns care.     

烧伤创面愈合的理论探索与临床实践

The basic and clinical research in wound healing have made great progress in China in the past 50 years. The method of " intermingle skin transplantation" which was first advocated by surgeons of Ruijin Hospital in 1966 greatly reduced the amount of autologous donor skin, thus making the coverage of an extensive burn wound possible. This method is al so known as " Chinese therapy". In 1986,doctors of Jishuitan Hospital reported successful coverage of an extensive burn wound with mieroautografts and allogeneic skin. The basic research of wound healing has been carried out since 1992,a series of studies showed the characteristics of biological behaviours of cells in concern, extracellular matrix and growth factor, the mechanism underlying progressive injury in deep second burn wound, the effect of " skin island" and the local immune tolerance induced by it (which are the key factors of intermingle transplantation).The induction of local immune tolerance has now become the re search hot subject of skin transplantation immunology. Stem cell research in the field of wound healing has been extensively car ried out. The theory of " dermal template defection" has been proposed as one of the mechanisms of scar formation. On the other hand, great progress has been achieved in the treatment of bums on the basis of clinical researches. Doctors of PLA 304 hospital found that excision of eschar on patients with extensive deep burn injury at early shock stage greatly decreased the occurrence of complications and mortality. Doctors of Ruijin Hospital reported that healing of deep second burn wound could be improved by tangential excision of burn eschar within 24 hours after burn injury. Doctors of Xiang ya Hospital reported patients suffering from deep bums of the hands got satisfied functional restoration when treated with tangential excision of eschar while degraded dermal tissue could be retained with transplantation of autoskin grafts.     

45例大面积烧伤患者的救治分析

目的:总结大面积烧伤患者的救治体会.方法:对我院收治的45例烧伤总面积超过50%TBSA的大面积烧伤患者给予补液、呼吸支持、创面处理、营养支持、抗感染及激素、乌司他丁等药物治疗.比较不同预后患者年龄、烧伤面积、住院时间、并发症等情况.结果:26例患者治愈,7例死亡,12例放弃治疗.放弃治疗组患者年龄明显大于治愈组(P<0.01),但与死亡组差异不显著(P>0.05);治愈、死亡和放弃治疗的患者间烧伤总面积差异无显著性(P>0.05),但治愈组III度烧伤面积显著小于放弃治疗组(P<0.01)和死亡组(P<0.05).放弃治疗的主要原因是病情严重、年龄偏大和经济负担重.26例治愈患者于伤后6周基本完成创面修复,裸露创面在5%以下.伤后出现的并发症包括脓毒症、心包积液、胸腔积液、肺感染、感染性心内膜炎、应激性糖尿病和反应性精神异常.创面培养细菌主要为铜绿假单胞菌(26株)、金黄色葡萄球菌(19株)、肺炎克雷白菌(15株)和醋酸钙不动杆菌(15株).7例死亡患者中3例死于烧伤脓毒症,4例因治疗后期家属放弃积极治疗而死亡.结论:有效的液体复苏、维持呼吸道通畅、积极的创面修复和有力的抗感染治疗是大面积烧伤救治成功的关键环节.烧伤感染是导致烧伤死亡的重要原因.     

水动力清创系统在上肢电弧灼伤创面的应用

目的:观察水动力清创系统(水刀)用于上肢电弧灼伤创面清创的效果.方法:2014年5月—2015年5月上海电力医院收治的53例上肢电弧灼伤患者,随机分为观察组(26例)和传统组(27例).观察组创面采用水刀技术治疗;传统组采用磨痂、削痂技术治疗.两组创面清创后均给予生物敷料(基因转染猪皮)覆盖创面.比较两组患者清创手术时间、创面愈合时间及瘢痕增生情况.结果:所有患者术后随访3~6个月.与传统组比较,观察组的手术时间、创面愈合时间均明显缩短,愈后瘢痕增生轻,差异均有统计学意义(P<0.05).结论:水刀技术可缩短上肢电弧灼伤创面的手术时间、创面愈合时间,创面愈合情况良好,瘢痕增生轻.     

生长激素在成人大面积深度烧伤的应用

OBJECTIVE: To determine the wound healing effect of rHGH in adult burn patients. METHODS: 16 patients with burn wounds covering over 60% of total body surface (TBSA) were enrolled in this placebo controlled prospective study. They were comparable in nutrient intake, TBSA, and full thickness burn area. rHGH group patients were given rHGH subcutaneously in the dose of 0.3u.Kg-1 at 8 am each morning for 10 days beginning from POD 1. The control group patients were given normal saline as placebo. All the patients received scar excision within 4 days postburn, and the excision wounds were covered with autologous skin pulp grafting. Serum amino acid profile was analyzed at day 1 and day 20 post burn. Healing time of burn wound area and donor site was recorded. Wound healing rate was assessed at day 30 after day. RESULTS: 1. The healing time of autologous skin pulp grafting and donor site, and the length of hospital stay were significantly shorter in GH group patients than control group. 2. The amino acid profile showed no difference between two groups at day 1 and was significantly better in GH group at day 20. CONCLUSION: rHGH could enhance the wound healing rate, improve amino acid profile, and reduce the length of hospital stay of severe burn patients.     

重组人生长激素应用于烧伤治疗的临床评价

目的　观察重组人生长激素 (rhGH)用于烧伤治疗的有效性及安全性。　方法　在全国 5家烧伤单位 ,采用前瞻性同步随机对照方法 ,将伤后 5d内入院的烧伤面积 >2 0 %TBSA、年龄 2 0～ 5 5岁的 2 0 0例患者随机分成手术组和非手术组 ,每组再随机分为对照组 (N组 )、rhGH 0 .2U·kg-1·d-1治疗组 (A组 )和rhGH 0 .4U·kg-1·d-1治疗组 (B组 ) ,比较各组的一般情况、蛋白质与糖代谢变化、免疫功能、尿生化指标、创面愈合率及住院时间等。　结果　A、B两组与N组比较 ,血浆蛋白含量显著增加 ;免疫功能恢复较快 ;创面愈合时间明显缩短 ,愈合率明显提高 ;体重无明显变化 ;住院时间明显缩短 ,但血糖及胰岛素的浓度升高 ,尿钾、钠、氯的排出量减少。B组较A组疗效显著 ,但不良反应发生率相应增加。手术组不良反应发生率高于非手术组。　结论　rhGH能有效促进蛋白质合成 ,提高机体免疫功能 ,加快创面愈合 ,缩短住院时间 ,但应正确选择用药时机和剂量     

Moist exposed therapy of partial-thickness burn wounds. A multi-center study

Summary In laser-induced partial-thickness burns of pig skin, moist exposed burn ointment (MEBO) produces a moist environment, allows drainage of exudates, reduces eschar formation, and accelerates debridement and wound healing. A prospective multi-center study was conducted to evaluate the effect of MEBO on the healing of partial-thickness burn wounds. We included 52 patients with 100 burn sites ranging from 0.5% to 15% total body surface area in the study. Treatment efficacy was assessed on physical examination of the wound, the course of time of trans-epidermal water loss (TEWL) and moisture values, bacterial wound colonization and the degree of pain experienced by patients during and between dressing changes. Using the Visual Analogue Thermometer device (VAT) a progressive decrease of pain was found throughout the treatment which was statistically significant at 6, 9 and 12 post-burn days. TEWL, as an indicator of re-epithelialization, demonstrated a decreasing trend on day 3, and the reduction became significant from the 6th post-burn day. Moisture was significantly decreased during the first 5 post-burn days. As re-epithelialization progressed there was a net decrease in moisture paralleling TEWL. After 1 week of MEBO treatment, bacterial wound colonization decreased to 10% in the immediate group and to 61% in the late group of application. By the second week, colonization dropped to 5% and 23% respectively. Topical ointment application contributed to the debridement of the wound bed facilitating rapid epithelialization within 2–6 days, depending on the burn depth. MEBO is an ointment that can effectively produce a moist and wet environment for optimal healing of partial-thickness burns.     

重组人生长激素在严重烧伤病人中的应用研究

目的 探讨生长激素对大面积烧伤病人蛋白质代谢、创面愈合能力、免疫功能及预后的作用。方法 选择４２例大面积烧伤病人,随机分为重组人生长激素治疗组和对照组,并分析比较两组一般状况、蛋白质代谢、创面愈合时间、免疫功能,结果 ｒｈＧＨ组一般情况良好,体重增加,血浆蛋白质水平,供皮区愈合时间及体液和细胞免疫功能均比对照组好。结论ｒｈＧＨ能有效促进蛋白质合成,缩短创面愈合时间,增强机体免疫能力,从而提高大面积     

早期负压封闭引流治疗深Ⅱ度烧伤创面的临床疗效评价

目的 前瞻性评价早期VSD治疗深Ⅱ度烧伤创面的临床疗效,为其临床应用提供依据.方法 选择笔者单位2009年5月-2010年3月收治的双下肢烧伤后3 h内入院、总面积小于10%且各下肢深Ⅱ度面积大于1%TBSA的患者22例.依照部位对称、深度相同、面积相近等同体对照原则,将每例患者创面分为VSD治疗组(应用VSD治疗)与对照组(应用10 g/L磺胺嘧啶银霜换药).观察2组患者创面的水分蒸发量、肿胀程度、细菌定植情况、疼痛程度、愈合时间及愈合质量并进行比较分析.数据行t检验与秩和检验.结果 21例患者完成试验,均在伤后4 h内完成创面处理.VSD治疗组正常皮肤及覆盖敷料前创面的水分蒸发量与对照组相近(t值分别为1.310、-0.911,P值均大于0.05);创面覆盖敷料2 h后,敷料表面的水分蒸发量[(44.3±3.9)mL·h-1·m-2]明显少于对照组[(66.1±6.4)mL·h-1·m-2,t=-11.39,P<0.01].伤后3、7 d,VSD治疗组大腿周径较伤后5 h分别增加了(3.48±0.35)、(2.51±0.21)cm,明显小于对照组的(8.02±0.41)、(3.99±0.32)cm(t值分别为4.110、3.569,P值均小于0.01).2组创面入院时及伤后10 d细菌培养阳性率组间比较,差异均无统计学意义(Z值分别为-0.894、0.000,P值均大于0.05);2组伤后10 d细菌培养阳性率均较各组入院时显著降低(Z值分别为-3.220、-3.870,P值均小于0.01).VSD治疗组创面伤后10 d的pH值(7.12±0.06)呈现弱酸性,对照组(7.41±0.13)则为中性.VSD治疗组伤后1、3、7 d创面疼痛程度轻于对照组(t值分别为-16.132、-21.230、-16.453,P值均小于0.01).2组创面愈合时间比较,差异无统计学意义(t=1.186,P>0.05).伤后2、3个月VSD治疗组创面愈合质量评价为佳(100.00%、100.00%),明显优于对照组(19.05%、85.71%,Z值分别为-11.638、-3.870,P值均小于0.01).结论 早期VSD治疗不能使深Ⅱ度烧伤创面愈合时间提前,但能显著提高其愈合质量,是处理深Ⅱ度烧伤创面的有效方法之一,值得临床关注与进一步研究.