| ObjectiveWound debridement dressing has been a normal subsequent therapy after depth burn with tangential excision and stamps skin or a large piece skin grafting.This therapy always bring a lot of adverse reactions,for example,wound infection,local edema,lower survival rate of the skin grafting and not ideal of wound healing.Consequently,Vacuum Sealing Drainage(VSD)is applied to clinical therapy to improve the adverse reactions.This study aims to quantitative compare extensive depth burn(EDB)with tangential excision skin grafting(TESG)with treatment of VSD to wound debridement dressing in the effect of skin graft healing process and outcome quality of wound healing and to analysis of its influencing factors.In order to provide a clinical reference for the feasibility of clinical application of VSD technology.MethodsRigorous criteria of cases selection were set.Clinical data were retrospectively reviewed for all consecutive adult patients 35 cases of the limbs and trunk deep Ⅱ-IⅢdegree burns of cut excision surgery with treatment of VSD(group A)at Burn Center,Jinan Central Hospital Affiliated to Shandong University,from March 2014 to December 2016;And 43 cases of the limbs and trunk deep Ⅱ-Ⅲ degree burns of cut excision surgery with conventional treatment debridement and dressing(group B).By Analysis of Variance and comparison of group A and B are two different treatments for first skin graft success rate,14d subsequent skin graft survival rate and complications,wound healing time,healing quality differences in the number of dressing and hospital costs.ResultsThere totally were 35 patients with 38 times of surgery to be included in the study in group A.17 of these were male and 18 were female.Their mean age was(31.74±30.67)years,total burn area was(6.83 ±5.95)%total body surface area,the area of deep Ⅱ degree burn injury(4.37±5.24)%total body surface area,the area of deepⅢdegree burn injury(2.46±1.77)%total body surface area;There totally were 43 patients with 49 times of surgery to be included in the study in group B.25 of these were male and 18 were female.Their mean age was(35.44±23.69)years,total burn area was(8.09 ±7.45)%total body surface area,the area of deep Ⅱ degree burn injury(5.12±6.40)%total body surface area,the area of deep Ⅲdegree burn injury(2.98±1.99)%total body surface area.There was no significant difference between the two groups in statistics with Analysis of Variance.There are 3 cases of 35 patients should have a skin graft surgery again in A group;There are 6 cases of 43 patients should have a skin graft surgery again in B group.The survival rate of skin grafting in group A is(87.43±19.79)%total body surface area.The survival rate of skin grafting in group B is(75.00±25.10)%total body surface area.;The healing time of group A was(22.06±10.79)days,The healing time of group B was(28.74±13.37)d;The number of dressing in group A was(5.77±3.17)times,The number of dressing in group B was(9.5314.05)times;The healing quality of group A was(3.46 ± 0.78),and the healing quality of group B was(2.86 ± 1.01);The cost of hospitalization in group A was(40282.49 ± 17464.59)Yuan,the cost of hospitalization in group B was(35301.60 ± 30587.53)Yuan.There were no significant in statistics of the survival rate of the first skin graft and hospitalization costs(P>0.05).The survival rate at 14 days after operation and healing time of skin graft were statistically significant(P<0.05).The number of dressing and the healing quality were statistically significant(P<0.01).ConclusionsCompared vacuum sealing drainage and Debridement with skin grafting therapy with traditional debridement dressing after tangential excision and skin grafting in extensive deep burns,it reduced the average number of dressings and improve the quality of healing significantly;it shorten the healing time of residual wounds and improved the 14 days survival rate of skin grafts after operative effectively.Although the average cost of hospitalization in the treatment group was higher than that in the conventional dressing group,there was no statistically significant difference.In the number of operations,the two treatment methods of the first skin graft success rate is very high,no statistically significant differences.In summary,the technique is simple in operation and convenient for postoperative care.It is an ideal treatment method after skin grafting.May be due to shorten the hospital stay,so the cost of hospitalization is not significantly higher than the traditional dressing treatment,in general,it is worth to be integrated in clinical application. |
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