| Objective:Children are at high risk of burn.In China,pediatric burns account for 21%of accidental injuries in children,and more than 1/3 of the burn inpatients during the same period.Pediatric burns are mainly scald about small and medium areas.Some areas which contact with hydrothermal fluid initially or contact with hydrothermal fluid for a long time are mostly deep scald.Negative pressure wound therapy(NPWT)for pediatric burn wounds can effectively remove the exudation of wound,reduce cellular edema,improve local microcirculation,accelerate wound healing,reduce the frequency of dressing change,and relieve the pain in the process of treatment.Acidic fibroblast growth factor(aFGF)was a polypeptide growth factor which could promote the growth of granulation,activate the immunity of body and improve the nutrition of wound.Researches have confirmed that aFGF treating in deep second-degree burn wounds has the effect of promoting growth.Some Chinese clinical trials about the combination of NPWT and aFGF in the treatm ent of residual burn wounds have showed that the wound healing time and 10±2d wound healing rate in the treatment group was better than that in the control group.At present,there has been no relevant literature report on the combination of NPWT and aFGF in the treatment of deep second-degree burn wounds in children.On basis of great clinical effects of NPWT and aFGF in the treatment of deep second-degree burn wounds in children during the earlier stage,this project makes the combination of NPWT and aFGF in the treatment of deep second-degree burn wounds in children,exploring the best use of NPWT and aFGF,and evaluating its clinical efficacy based on the principle of evidence-based medicine.Methods:73 children with deep second-degree burn wounds who were admitted to the burn surgery department of Jinan Central Hospital from January 2019 to January 2021 were selected in this study.According to the different treatment,the children were divided into group A(combination of NPWT and aFGF treatment),group B(NPWT treatment)and group C(dressing change treatment).After admission,all patients were treated with debridement and disinfection,appropriate fluid replacement,prevention of infection and other treatment measures.Patients in the group A were treated with the combination of NPWT and aFGF within 72h after injury,then the conventional treatment was used after 7 days.Patients in the group B were treated with the NPWT within 72h after injury,then the conventional treatment was used after 7 days.In group C,the wound surface was externally coated with arnebia root oil-silver ion antibacterial dressing,and the sterile dressing was wrapped and fixed.The dressing was changed about 3-4 days,and 1%silver sulfadiazine cream was added if necessary until the wound healing.The wound healing rate on the day of 10±2d,the time of epithelialization,the frequency of dressing change,the incidence of adverse events and laboratory test values were observed in each group.Results:Obvious pain had occurred in two children during the period of NPWT treatment,and the symptom was significantly relieved after the pressure lowered.One child in group C had slightly low serum potassium on the day of admission,which could be observed after symptomatic treatment.The wound healing rate on the day of 10±2d:group A>group B>group C and the data was statistically significant(P<0.01).The time of epithelialization of burn wounds about three groups:group A<group B<group C and the data was statistically significant(P<0.01).Dressing change times:group A<group B<group C and the data was statistically significant(P<0.01).Conclusions:Treating deep second-degree burn wounds in children with the combination of NPWT and aFGF can effectively shorten the time of epithelization,reduce the frequency of dressing change,relieve patients’ pain and improve the quality of deep wound healing.According to clinical observation,this method is safe,simple but highly effective,worthy of clinical application. |
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