| Background:Good coverage of the wound is always the surgeon in thethinking of problem. In recent 50 years, A variety of wound covering have been produced, in the joint efforts of the domestic and foreign counterparts. Combined with the application of a variety of wound covering or dressing, combined with dressing and operation treatment, these methods have been gradually adopted by modern doctors, and obtain the satisfactory effect. At the same time, the majority of physicians in the habit of using biological dressing in dermabrasion surgery, but they also found some shortcomings made him very unhappy. For example, the latter is easy to dry and harden, aggravate the pain; and even biological dressing is easy to fall off, then the drug dissolved scab, duration of treatment effect is poor. How to realize the "painless" treatment, improve the curative effect, How to alleviate the suffering of patients, reduce the economic burden of the patients, how to improve the quality of healing, reduce complications. How to make the patients actively cooperate with the treatment, doctors to reduce the medical dispute... This is our efforts direction. In the existing research and clinical applications, mainly used in dry hydrogel dressingwounds, chronic wound, Currently little about application of hydrogel dressing grinding excision after detailed clinical study reports, Further study and explore the clinical application of the hydrogel dressing.Objective:The application of hydrogels was observed and analyzed after the grinding. To investigate the feasibility of treatment of combined application of hydrogel dressing and grinding excision, to improve the effect of treatment. And to provide a new thinking and new method for wound treatment.Method:We choose 68 deep two degree burn patients in our hospital from 2013 November to 2014 September were treated patients, record the patients basic information such as, the number of hospitalized time, injury and injury factors, the hospital time, contact telephone number, examination, examination results (three conventional, liver and kidney function, wound secretion bacterial culture). In line with the conditions of the patients randomized to treatment group and control group of two kinds of treatment. The two groups were given to improve early preoperative examination and preparation before operation, give the empirical application of antibiotics to prevent infection in intravenous drip, giving a vasodilator drugs and promoting blood circulation to promote micro circulation, treatment of nutritional support necessary, water-soluble vitamins in 1 branches two sodium triphosphate, coenzyme complex 20mg 0.1 is added to the liquid infusion, for far infrared therapy, the integrated therapy and improve the operation tolerance.3 days of general surgery in patients after admission, then all the preparation before operation is finished, the patient is relatively stable, the operation was well tolerated, and less bleeding during the operation; late obvious inflammatory reaction, wound bleeding, swelling obviously. Treatment group:Dermabrasion surgery, after hemostatic treatment, immediate application of hydrogel dressing, and then covered with vase line gauze oil layers of sterile gauze bandage, thick layer. While the control group wounds were suspended good blood directly on a cover of oil and vaseline gauze, thick layer of gauze. Course of treatment:every 3 days for a treatment, the total treatment time is generally not more than 1months, in order to ensure the overall effect of patients, operation intervention beyond. The wound healing were treated with elastic bandage pressure scar treatment, at the end of the three month growth of scar assessment.Results:In 68 cases of deep two degree burn were selected, male 52 cases, female 16 cases; age 2 years old to 65 years old, average 40.5 years old. The causes of injury for flame burn and scald. The treatment group after preoperative preparation, application of hydrogel dressing grinding excision, the healing and healing time, bacterial culture of wound exudate, wound dressing area of liquid, pain, adhesion and so on, were better than the control group. Reduce the number of dressing change, reduce the number of re operation, each of the two groups of patients of 10 cases were later to ensure the joints, functional activities, were treated by skin grafting. In the non joint treatment group in 18 days or so much healing; positive for elastic sleeve compression in the treatment of scar after healing, observed after 3 months of growth,the effect is satisfactory. Through our research found that:the application of hydrogels with tangential excision surgery, wound secretion was significantly reduced, easy to clean, dressing process is simple; and the skin around the wound without dipping, no inflammatory reaction; pain significantly reduced, the course of treatment in patients with more coordination, harmonious doctor-patient relationship; wound dressing with little adhesion, newborn the organization is not destroyed, the wound healing time was significantly shorter, higher quality of wound healing; scar hyperplasia of light.Conclusion:1.The hydrogel dressing combined with eschar grinding used in deep two degree burn, not only timely and effective removal of necrotic tissue, and as much as possible to retain theecological organization, make full tissue healing.2.Wounddressing effusion, adhesion of light, to reduce the tissue damage, reduce the painof patients wound dressing; few bacteria reduced the use of antibiotics, reduce the number of treatment before operation. Wound healing or operation at short intervals; reduce theworkload of the clinician when dressing.3. The wound scab grinding operation combined with postoperative application of hydrogeldressings forthetreatmentofdeep partial twodegree deep, obvious converge nce wound, promote wound epithelial growth, reduce the wound surrounding tissue damage. After the foundation of anti scarring healing treatment, less scar growth. |
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