A Clinical Trail Of Early Dermabrasion On Deep Second Degree Burns To Influence Body's Inflammatory Response And Wound Healing

【Objective】Our purpose was to investigate the safety of early electro-drivendermabrasion applying to deep second degree burn wounds and its preventive andtherapeutic effects to systemic inflammatory response syndrome(SIRS) ofpostburn.Meanwhile,we want to observe and evaluate the influence of electro-drivendermabrasion on wound healing in this trail.【Methods】1.Patients grouping andtreatment:75 patients(ages from 18 to 60,not to confine their gender) with extensive deepsecond degree burn were selected.This cohort was randomly divide into threegroups,including electro-driven dermabrasion (A group,n=25),tangential excision (Bgroup,n=25) and nonoperation (C group,n=25).All the patients were hospitalized atshock stage. After administrating routine fluid resuscitation and supportive therapy.Weoperated on them by dermabrasion or tangential excision on the 3rd or 4th day ofpostburn.Then we covered the frozen and irradiated xenoskin on the wounds.thenonoperation-patients were covered with 1% SD-Ag cream.Renoveaturing the dressingwould be done regularly to the all patients until their wounds healed. 2.Observationindexes:(1)The wounds'tissue were confirmed whether it was or it wasn't deep seconddegree burns by pathological diagnosis before treatment.(2) tissue specimens weretaken from the wound beds after the operation to show that eschars were removed clearlyby pathological diagnosis.(3)The eschars tissue which were removed by operation hadbeen observed their activity by pathological diagnosis.(4)We detected the level oftumour necrosis factor-alpha (TNF-α) ,interleukin-6(IL-6) and nterleukin-8(IL-8) of theperipheral veinal blood of every group at shock stage,on the fifth-day,eighth-day andeleventh-day of postburn.(5) We recorded regularly all patients'mental status,symptomsand signs of abdominal regions,hypistomas'status,temperatures,heart rates andrespiratory rates.To detect bacteria's amount of tissue under the eschars when itnecessary.Meanwhile,We conducted their blood as routine examination and then observethe incidence of SIRS in all patients in different time of postburn ,according to SIRS'sdiagnostic criteria.(6)To observe their healing time, the character of histopathology whenwounds healing and scars'hyperplasy status of all groups'wounds after 6 months.【Results】(1)mainly changes of pathology: The wounds tissue were verified deepsecond degree burn by pathological diagnosis before treatment. The wound bedsremain much more appendages of the skin and viable dermis in group A than that ingroup B.(2)The level of some inflammatory mediators :the level of TNF-α,IL-6 andIL-8 in sera were not different in all groups after postburn shock stage and on the 5thday(P>0.05),but the indices in groupAand B were significantly lower than that in groupC (*P<0.01,#P<0.05).(3)The incidence of SIRS: The incidences of SIRS in all patientswere not different at shock stage and postburn 5th day(P>0.05),but it decreasedconspicuously in group A and B than that of the group C postburn 7th day and 14thday(*P<0.01, #P<0.05). (4) Time of wounds healing: the time of wounds healing ingroupAwas shorten 4 to 5 days than that of group B(P<0.01),while it was shorten 7 to 8days than that of group C(P<0.01).(5)The status of wounds scar hyperplasy: the scarindex (SI) on wounds in groupAless than that of the group B and C(P<0.01).【Conclusions】(1)The manufacture of electro-driven dermabrasion instrument issimply and cheap at its cost.It is convenient,pragmatic and safe of itsoperation.(2)Treatment of deep second degree burn wounds with electro-drivendermabrasion can also relieve the inflammatory response on bodies and decrease theincidence of SIRS compares to the treatment of tangential excision.(3)Contrasting tothe tangential excision, the electro-driven dermabrasion at early stage can removesufficiently necrotic tissues of deep second degree burn wounds while retains much moreviable appendages of the skin and dermis,and its injuries is less than the tangentialexcision.Therefore the treatment of electro-driven dermabrasion will shorten wound...