The Early Treatments Of Batch Extensive Deep Burn Patients

Object:To investigate the early treatments of batch extensive deep burn patients.Methods:Retrospective analysis of 33 cases of heavy deep burn patients between August 2014 to July 2015 in KUNSHAN explosion accident,25 males,8 females, age from 20 to 54 years old, average age 36.46±6.02, total burn surface area was about 51%-99%, the average area was 96.69±11.25%,third degree burn area was about 45% to 96%,89.30 ±6.52% on average, all were caused by explosion injury,and all were accompanied with different degrees of inhalation injury, without obvious history of diseases, such as diabetes, cancer and chronic organ disease.After admission,the preventive tracheotomies were performed;Vein incisions or deep vein punctures were set up to establish a rapid and effective channels for intravenous infusion;Escharotomies were performed for during 24 hours,so as to improve body blood circulation and ventilation function;Escharectomies were completed within 2 weeks, after of shock stage or patients life signs were basically stable,and then covered the wound with homograft,autologous microskin graft,postage stamp grafting and Meek skin grafting to repair the wound; With porcine acellular dermal matrix covered the wound of joint escharectomy.At the same time,cooperated with the non-surgical treatments such as continuous negative pressure drainage technology,Suspended bed,Hemodialysis(HD)and so on.Result:The study of 33,all were severe deep burn patients,19 survived,14 died.After injury,the patients of 6 cases healed in 45 days,7 cases healed in 60 days, and 6 cases all healed in 90 days. Followed up for 1 year,of the 15 survival cases,10 cases of them can basically live on their own.Conclusion:Early preventive tracheotomy,establishment of a quick and effective channel of intravenous infusion;escharotomies to decompression as early as possible,early escharotomy and repaired the wound with allograft skin, autologous microskin graft,postage stamp grafting or Meek skin grafting were the key point to treat the batched severe deep burn patients,and combined with continuous negative pressure drainage technology,Suspended bed,Hemodialysis(HD),so as to improve the survival rate of the flap and the successful rates of rescue.