| Objective: Using self-control, taking72cases of burn patients as theresearch object, to observe the clinical effect of external Recombinanthuman epidermal growth factor Gel,(Rh-EGF) and Sulfadiazine zincsilver ointment which curing the deep II degree burn wounds, toinvestigate the advantage of drug combination in promoting woundhealing and the value of clinical application. Methods:72cases of burnpatients(Age18-65, all genders, TBS:47cases were5%-30%,14of30-50%and>50%in11cases) treated by The Affiliated Hospital ofLuzhou Medical College of burn surgery department during2012-2013is the main study, use open clinical observation method, select one, thesame depth, similar or symmetrical parts of deep II degree burn wounds,which observation area of about10*10cm2, then randomly divided intocombined treatment group (treatment group) and the single use ofRh-EGF group (contrast group) for its own control study. Each groupcovered3-5mm thick drug, inner layer of interval with Vaseline gauze,the outer sterilized dressing properly fixed, dressing change once a day.Treatment group according to the proportion of1:1, mix together Rh- EGF gel and Sulfadiazine zinc silver ointment, make ready to use anytime. In4days after the injury,8days,20days,14days,28days forobservation, recorded and photographed before dressing to detect twoundhealing rate(WHR); observe the dissolution of scab and PiDao formationwith the naked eye; take wound secretions for bacterial culture,identification and drug sensitivity testing; finally, record the woundhealing time of both groups, and observe whether patients with adversedrug reactions. Results:(1) wound macroscopic observation: Dissolvewound scab effect of treatment group is more obvious than contrast group,and dissolved scab time significantly shortened2-4days, scab skin inbasic clean after4to6days, and the treatment group more ruddy, PiDaois especially obvious. During the expanding of fusion to wound healingprocess, PiDao is relatively clean and less exudation.(2) woundgermiculture positive rate: By using the Wilcoxon rank and test analysis,bacteria detection rate of two groups at different time phase point, showsthat treatment group at8d,14d,20d wound bacteria detection rate of15%,22%,12%, respectively lower than that of contrast group26%,41%,37%, differences were statistical significance. The positive rate ofbacteria culture in two groups is: treatment group11.9%and contrastgroup24.1%, treatment group wound bacteria detection rate is lowerthan contrast group obviously, inspection differences were statisticalsignificance (P <0.05). In cultivating bacteria: first: pseudomonas aeruginosa, the second: staphylococcus aureus(SA), the third: Escherichcoli(E. coli).(3) wound healing ratio (WHR):4days after injury, twogroups have no obvious statistical significance (P>0.05). Treatmentgroup in8days after injury,14days,20days,28days of wound healingrates were29.43±1.41，67.46±1.90，96.69±6.53，100.0±0, significantlyhigher than that of contrast group18.69±1.58，49.05±4.42，79.00±3.82，98.78±5.02, and each time difference between the two groups havestatistical significance (P <0.05).(4) the wound healing time: treatmentgroup was (21.37±6.95)d, contrast group was (27.16±5.77) d, obviously,wound healing time of treatment group was faster than contrast group4-6days, differences were statistical significance (P <0.05).(5) adversereaction: during the study found that8patients in treatment group withsubjective feeling of burning pain after treatment, duration in30minutesand without taking pain medicine, no adverse reaction on treatment. Intwo sets of each time phase,3cases of contrast group appeared red andswollen on wound edge, much secretions from the inner layer of gauze,which will be gradually improved after dressing treatment. Throughexamination for patients such as blood routine, ALT, AST, creatinine andurea nitrogen etc., found none of adverse reactions associated withexternal use medicine.Conclusion: In deep II degree burn woundtreatment, the Recombinant human epidermal growth factor (Rh-EGF)combined with Sulfadiazine zinc silver ointment can together play a role of antibacterial effects and promoting wound healing, also can effectivelyshorten the deep II degree burn wound healing time, which can be usedfor clinical application. |
PDF Full Text Request